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General NPI Number Information
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NPI Number | 1326027376
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Entity Type | Individual
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Provider Name | KHALIL B KORKOR M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/10/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4124 MUNSON ST NW SUITE A
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City | CANTON
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State | OH
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Zip | 44718-2979
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Country | US
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Telephone | 330-492-6662
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Fax | 330-492-6918
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Provider Business Mailing Address
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Address Line | 4736 ARMANDALE AVE NW
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City | CANTON
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State | OH
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Zip | 44718-2279
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Country | US
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Telephone | 330-966-7762
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 35046973
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License Number State | OH
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