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General NPI Number Information
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NPI Number | 1386139624
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Entity Type | Individual
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Provider Name | JOEL MATTHIAS BIESTER MD
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Gender | Male
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Dates
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Enumeration Date | 06/28/2018
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Last Update Date | 07/16/2024
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Provider Practice Location Address
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Address Line | 1120 15TH STREET
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City | AUGUSTA
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State | GA
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Zip | 30912-0004
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Country | US
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Telephone | 706-721-8623
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Fax | 706-721-1459
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Provider Business Mailing Address
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Address Line | 1120 15TH ST # OR6000
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City | AUGUSTA
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State | GA
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Zip | 30912-0004
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Country | US
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Telephone | 706-721-3813
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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 | 52662
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 100353
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License Number State | GA
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