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General NPI Number Information
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NPI Number | 1316111560
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Entity Type | Individual
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Provider Name | CHANDRALEKHA CHANDRAKANT PUJARA MD
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Gender | Female
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Dates
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Enumeration Date | 04/18/2008
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Last Update Date | 04/18/2008
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Provider Practice Location Address
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Address Line | 5298 POND BLUFF DR
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48323-2442
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Country | US
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Telephone | 248-681-7022
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Fax | 248-681-1074
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Provider Business Mailing Address
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Address Line | 5298 POND BLUFF DR
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48323
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Country | US
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Telephone | 248-681-7022
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Fax | 248-681-1074
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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 | 2080I0007X
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Taxonomy Name | Pediatric Clinical & Laboratory Immunology Physician
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License Number | 4301038580
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License Number State | MI
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