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General NPI Number Information
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NPI Number | 1275563298
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Entity Type | Individual
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Provider Name | ANGELA TONI COREA MD
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Gender | Female
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 03/26/2021
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Provider Practice Location Address
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Address Line | 1000 E MAIN ST
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City | DANVILLE
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State | IN
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Zip | 46122-1948
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Country | US
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Telephone | 317-745-4451
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Fax | 317-718-6740
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Provider Business Mailing Address
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Address Line | 10330 N MERIDIAN ST SUITE 201
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City | INDIANAPOLIS
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State | IN
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Zip | 46290-1024
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 01059781A
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License Number State | IN
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