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General NPI Number Information
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NPI Number | 1285845115
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Entity Type | Organization
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Legal Business Name | ANDREW M. FOX MD LLC
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 05/20/2010
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Provider Practice Location Address
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Address Line | 53 S PUUNENE AVE SUITE 102
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City | KAHULUI
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State | HI
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Zip | 96732-2192
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Country | US
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Telephone | 808-871-8611
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Fax | 808-893-0211
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Provider Business Mailing Address
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Address Line | 53 S PUUNENE AVE SUITE 102
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City | KAHULUI
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State | HI
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Zip | 96732-2192
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Country | US
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Telephone | 808-871-8611
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Fax | 808-893-0211
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANDREW MICKLE FOX
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Credential | M.D.
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Telephone | 808-871-8611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD10042
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License Number State | HI
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