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General NPI Number Information
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NPI Number | 1275638231
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Entity Type | Individual
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Provider Name | MAHIR MATTI MD
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Gender | Male
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 11/12/2018
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Provider Practice Location Address
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Address Line | 769 S WAYNE RD
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City | WESTLAND
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State | MI
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Zip | 48186-4364
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Country | US
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Telephone | 734-331-3910
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Fax |
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Provider Business Mailing Address
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Address Line | 45453 RIVERWOODS DR
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City | MACOMB
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State | MI
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Zip | 48044-5785
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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 | 4301078766
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License Number State | MI
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