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General NPI Number Information
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NPI Number | 1245280783
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Entity Type | Individual
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Provider Name | CHARLES M BAILIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 11/16/2007
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Provider Practice Location Address
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Address Line | 26250 EUCLID AVE SUITE 203
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City | EUCLID
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State | OH
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Zip | 44132-3305
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Country | US
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Telephone | 216-261-2333
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Fax | 216-289-0748
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Provider Business Mailing Address
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Address Line | 275 SPRINGSIDE DR #100
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City | AKRON
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State | OH
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Zip | 44333-4548
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Country | US
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Telephone |
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 35-031712
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License Number State | OH
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