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General NPI Number Information
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NPI Number | 1346417250
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Entity Type | Individual
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Provider Name | KUMARAN CHINNAPPAN MD,FACS,FRCS,FASMBS
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Gender | Male
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Dates
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Enumeration Date | 05/09/2008
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Last Update Date | 02/22/2024
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Provider Practice Location Address
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Address Line | 12152 TESSON FERRY RD STE B
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City | SAINT LOUIS
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State | MO
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Zip | 63128-1779
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Country | US
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Telephone | 314-858-6172
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Fax |
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Provider Business Mailing Address
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Address Line | 9621 OLIVE BLVD #8344
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City | SAINT LOUIS
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State | MO
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Zip | 63132-9998
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Country | US
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Telephone | 314-690-1527
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 2010017407
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License Number State | MO
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