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General NPI Number Information
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NPI Number | 1245240563
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Entity Type | Individual
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Provider Name | RAIQA MUNIS M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 08/06/2015
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Provider Practice Location Address
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Address Line | 10803 MAIN ST STE 800
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City | FAIRFAX
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State | VA
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Zip | 22030-4728
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Country | US
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Telephone | 703-277-3346
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Fax | 703-277-3371
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Provider Business Mailing Address
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Address Line | 743 MILLER AVE
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City | GREAT FALLS
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State | VA
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Zip | 22066-2916
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Country | US
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Telephone | 703-395-7099
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Fax | 703-277-3371
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101056011
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License Number State | VA
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