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General NPI Number Information
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NPI Number | 1316986342
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Entity Type | Individual
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Provider Name | PHILIP BASILE DPM
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Gender | Male
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Dates
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Enumeration Date | 06/05/2006
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Last Update Date | 02/19/2011
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Provider Practice Location Address
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Address Line | 330 MOUNT AUBURN ST DIVISION OF PODIATRY
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City | CAMBRIDGE
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State | MA
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Zip | 02138-5502
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Country | US
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Telephone | 617-499-5065
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Fax | 617-321-4075
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Provider Business Mailing Address
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Address Line | 464 COMMON ST # 307
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City | BELMONT
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State | MA
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Zip | 02478-2704
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Country | US
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Telephone | 888-352-0082
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Fax | 617-321-4075
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | PD1920
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License Number State | MA
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