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General NPI Number Information
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NPI Number | 1306011440
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Entity Type | Organization
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Legal Business Name | THE NEUROLOGY CENTER PLC
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Dates
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Enumeration Date | 04/29/2008
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Last Update Date | 09/02/2010
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Provider Practice Location Address
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Address Line | 23 N HANCHETT ST
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City | COLDWATER
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State | MI
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Zip | 49036-1652
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Country | US
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Telephone | 517-278-3412
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Fax | 517-278-6115
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Provider Business Mailing Address
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Address Line | 23 N HANCHETT ST
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City | COLDWATER
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State | MI
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Zip | 49036-1652
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Country | US
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Telephone | 517-278-3412
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Fax | 517-278-6115
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Authorized Official
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Title or Position | OWNER
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Name | DR. DIMOSTHENIS COSTANTINOS DAFNIS
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Credential | M.D.
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Telephone | 517-278-3412
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 4301073404
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License Number State | MI
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