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General NPI Number Information
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NPI Number | 1356349815
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Entity Type | Individual
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Provider Name | MICHELLE ANN MIGLIORE DO
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Gender | Female
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Dates
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Enumeration Date | 07/08/2005
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 3371 W CLEVELAND ROAD EXT
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City | SOUTH BEND
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State | IN
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Zip | 46628-9780
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Country | US
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Telephone | 574-218-6700
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Fax | 855-540-2473
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Provider Business Mailing Address
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Address Line | 50965 BRIARWOOD CT
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City | GRANGER
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State | IN
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Zip | 46530-9779
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Country | US
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Telephone | 574-276-0857
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Fax | 855-540-2473
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 02001135
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License Number State | IN
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