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General NPI Number Information
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NPI Number | 1265851091
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Entity Type | Individual
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Provider Name | RASHID MOIN ANSARI M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/09/2014
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Last Update Date | 05/15/2025
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Provider Practice Location Address
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Address Line | 15033 BALLANCROFT PKWY STE 200
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City | CHARLOTTE
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State | NC
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Zip | 28277-4959
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Country | US
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Telephone | 704-316-2920
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Fax | 704-316-2921
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Provider Business Mailing Address
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Address Line | PO BOX 60447
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City | CHARLOTTE
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State | NC
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Zip | 28260-0447
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2019-00195
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD51329
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License Number State | SC
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