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General NPI Number Information
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NPI Number | 1275964934
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Entity Type | Organization
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Legal Business Name | MANA MEDICAL, INC.
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Dates
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Enumeration Date | 12/06/2013
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Last Update Date | 12/06/2013
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Provider Practice Location Address
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Address Line | 880 GREENLAWN AVE
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City | COLUMBUS
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State | OH
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Zip | 43223-2616
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Country | US
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Telephone | 614-449-9664
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Fax | 614-444-7919
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Provider Business Mailing Address
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Address Line | 8163 CAMPDEN LAKES BLVD
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City | DUBLIN
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State | OH
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Zip | 43016-8254
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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 | OWNER
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Name | BINIT J SHAH
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Credential | M.D.
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Telephone | 202-491-3733
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P2900X
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Taxonomy Name | Pain Medicine (Psychiatry & Neurology) Physician
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License Number | 35.097615
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 35.097615
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License Number State | OH
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