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General NPI Number Information
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NPI Number | 1386942548
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Entity Type | Organization
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Legal Business Name | MAXIMEYES INC
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Dates
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Enumeration Date | 03/11/2011
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Last Update Date | 03/11/2011
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Provider Practice Location Address
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Address Line | 381 STUYVESANT ST SUITE #2
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City | WARRENTON
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State | VA
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Zip | 20186-2400
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Country | US
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Telephone | 540-347-2217
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Fax | 540-686-7466
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Provider Business Mailing Address
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Address Line | 381 STUYVESANT ST SUITE #2
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City | WARRENTON
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State | VA
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Zip | 20186-2400
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Country | US
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Telephone | 540-347-2217
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Fax | 540-686-7466
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MINU SHAH
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Credential | O.D.
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Telephone | 919-302-6336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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