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General NPI Number Information
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NPI Number | 1275578809
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Entity Type | Organization
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Legal Business Name | URBAN MEDICAL GROUP
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Dates
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Enumeration Date | 06/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 545A CENTRE ST
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City | JAMAICA PLAIN
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State | MA
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Zip | 02130-2061
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Country | US
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Telephone | 617-522-5464
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Fax | 617-524-2966
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Provider Business Mailing Address
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Address Line | 545A CENTRE ST
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City | JAMAICA PLAIN
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State | MA
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Zip | 02130-2061
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Country | US
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Telephone | 617-522-5464
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Fax | 617-524-2966
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Authorized Official
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Title or Position | ADMINISTRATIVE DIRECTOR
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Name | EMILY BROWER
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Credential |
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Telephone | 617-522-5464
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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 |
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License Number State |
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