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General NPI Number Information
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NPI Number | 1326534264
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Entity Type | Individual
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Provider Name | LAURA CLINE MD
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Gender | Female
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Dates
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Enumeration Date | 07/03/2018
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Last Update Date | 07/03/2018
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Provider Practice Location Address
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Address Line | 5710 WOOSTER PIKE STE 102
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City | CINCINNATI
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State | OH
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Zip | 45227-4520
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Country | US
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Telephone | 813-713-0069
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Fax |
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Provider Business Mailing Address
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Address Line | 10649 N PARK AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46280-1019
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Country | US
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Telephone | 317-728-8818
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 01039640A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 01039640A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 01039640A
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License Number State | IN
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