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General NPI Number Information
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NPI Number | 1356520951
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Entity Type | Organization
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Legal Business Name | CAROMONT MEDICAL GROUP INC
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Dates
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Enumeration Date | 10/31/2007
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Last Update Date | 06/09/2010
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Provider Practice Location Address
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Address Line | 112 WOODLAWN RD
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City | MOUNT HOLLY
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State | NC
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Zip | 28120-1775
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Country | US
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Telephone | 704-827-3575
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Fax | 704-827-0840
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Provider Business Mailing Address
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Address Line | 112 WOODLAWN RD
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City | MOUNT HOLLY
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State | NC
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Zip | 28120-1775
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Country | US
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Telephone | 704-827-3575
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Fax | 704-827-0840
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Authorized Official
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Title or Position | PRESIDENT, CEO
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Name | VALINDA L RUTLEDGE
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Credential |
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Telephone | 704-834-2133
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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 |
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License Number State |
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