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General NPI Number Information
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NPI Number | 1386690766
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Entity Type | Individual
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Provider Name | WLADIMIR WERTELECKI MD
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Gender | Male
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 04/08/2008
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Provider Practice Location Address
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Address Line | 307 UNIVERSITY BLVD N CC/CB 214
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City | MOBILE
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State | AL
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Zip | 36688-3053
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Country | US
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Telephone | 251-460-7500
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Fax | 251-460-3837
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Provider Business Mailing Address
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Address Line | PO BOX 40480
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City | MOBILE
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State | AL
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Zip | 36640-0480
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Country | US
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Telephone | 251-470-5842
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Fax | 251-470-5809
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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 | 207SG0201X
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Taxonomy Name | Clinical Genetics (M.D.) Physician
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License Number | 6855
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License Number State | AL
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