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General NPI Number Information
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NPI Number | 1245203991
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Entity Type | Individual
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Provider Name | MICHAEL W BARRETT M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/10/2006
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Last Update Date | 05/02/2018
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Provider Practice Location Address
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Address Line | 2517 VESTAL PKWY E
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City | VESTAL
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State | NY
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Zip | 13850-2020
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Country | US
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Telephone | 607-798-1452
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Fax | 607-798-1792
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Provider Business Mailing Address
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Address Line | 1 GUTHRIE SQ
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City | SAYRE
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State | PA
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Zip | 18840-1625
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Country | US
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Telephone | 570-888-5858
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 187196
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number | 187196
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License Number State | NY
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