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General NPI Number Information
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NPI Number | 1336467554
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Entity Type | Organization
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Legal Business Name | EXPERT CARE INC
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Dates
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Enumeration Date | 05/12/2010
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Last Update Date | 05/12/2010
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Provider Practice Location Address
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Address Line | 1111 E SUMNER ST SUITE A
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City | HARTFORD
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State | WI
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Zip | 53027-1609
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Country | US
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Telephone | 262-627-0995
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Fax |
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Provider Business Mailing Address
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Address Line | 889 S RAINBOW BLVD #624
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City | LAS VEGAS
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State | NV
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Zip | 89145-6238
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Country | US
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Telephone | 262-627-0995
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | JOHN MOSES
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Credential | M.D.
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Telephone | 262-627-0995
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 33535020
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License Number State | WI
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