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General NPI Number Information
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NPI Number | 1356391114
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Entity Type | Organization
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Legal Business Name | HIGH POINT HEALTH CARE VENTURES
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 10/03/2008
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Provider Practice Location Address
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Address Line | 222 W. RAY STREET SUITE 102
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City | HIGH POINT
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State | NC
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Zip | 27262
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Country | US
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Telephone | 336-878-6064
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Fax | 336-878-6963
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Provider Business Mailing Address
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Address Line | 222 W. RAY STREET SUITE 102
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City | HIGH POINT
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State | NC
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Zip | 27262
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Country | US
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Telephone | 336-878-6064
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Fax | 336-878-6963
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Authorized Official
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Title or Position | DEPARTMENT OF PATHOLOGY
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Name | MRS. CYNTHIA DIANNE WELLMON
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Credential | BS. BA
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Telephone | 336-878-6064
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | LP00331
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License Number State | NC
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