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General NPI Number Information
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NPI Number | 1316937436
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Entity Type | Individual
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Provider Name | MINH TAM TRUONG MD
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Gender | Female
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Dates
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Enumeration Date | 10/28/2005
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Last Update Date | 03/19/2021
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Provider Practice Location Address
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Address Line | 830 HARRISON AVE MOAKLEY BUILDING LL100
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City | BOSTON
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State | MA
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Zip | 02118
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Country | US
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Telephone | 617-638-7070
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Fax | 617-638-7037
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Provider Business Mailing Address
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Address Line | 801 ALBANY STREET FL G
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City | BOSTON
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State | MA
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Zip | 02119-3791
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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 | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 221093
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License Number State | MA
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