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General NPI Number Information
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NPI Number | 1265771828
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Entity Type | Organization
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Legal Business Name | DONALD E NICOL MD INC
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Dates
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Enumeration Date | 02/01/2013
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Last Update Date | 12/08/2015
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Provider Practice Location Address
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Address Line | 549 HALEMAUMAU ST STE F
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City | HONOLULU
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State | HI
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Zip | 96821-2150
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Country | US
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Telephone | 808-373-2164
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Fax | 808-377-9705
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Provider Business Mailing Address
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Address Line | 549 HALEMAUMAU ST STE F
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City | HONOLULU
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State | HI
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Zip | 96821-2150
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Country | US
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Telephone | 808-373-2164
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Fax | 808-377-9705
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DONALD EDWARD NICOL
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Credential | MD
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Telephone | 808-373-2164
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 3657
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License Number State | HI
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