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General NPI Number Information
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NPI Number | 1376295501
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Entity Type | Organization
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Legal Business Name | SUMMERSIDE HEALTH PLLC
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Dates
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Enumeration Date | 01/19/2022
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Last Update Date | 01/19/2022
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Provider Practice Location Address
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Address Line | 1555 RAMAR RD
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City | BULLHEAD CITY
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State | AZ
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Zip | 86442-6010
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Country | US
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Telephone | 702-960-6930
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Fax |
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Provider Business Mailing Address
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Address Line | 9225 TUDOR PARK PL
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City | LAS VEGAS
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State | NV
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Zip | 89145-8726
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Country | US
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Telephone | 312-859-9392
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JONATHAN KWAN RHEE
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Credential | MD
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Telephone | 312-859-9392
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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 |
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License Number State |
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