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NPI 1407831696

NPI 1407831696 : THOMAS PATRICK DEMARINI MD : DECATUR, GA

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General NPI Number Information
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    NPI Number           |    1407831696
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    Entity Type          |    Individual 
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    Provider Name        |    THOMAS PATRICK DEMARINI MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    12/09/2005
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    Last Update Date     |    01/25/2010
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Provider Practice Location Address
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    Address Line         |    2665 N DECATUR RD STE 430
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    City                 |    DECATUR
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    State                |    GA
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    Zip                  |    30033-6145
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    Country              |    US
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    Telephone            |    404-294-4018
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    Fax                  |    404-294-1359
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Provider Business Mailing Address
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    Address Line         |    2665 N DECATUR RD STE 430
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    City                 |    DECATUR
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    State                |    GA
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    Zip                  |    30033-6145
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    Country              |    US
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    Telephone            |    404-294-4018
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    Fax                  |    404-294-9161
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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        |    207RP1001X
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    Taxonomy Name        |    Pulmonary Disease Physician
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    License Number       |    032171
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    License Number State |    GA
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Taxonomy #2
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    Taxonomy Code        |    207RC0200X
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    Taxonomy Name        |    Critical Care Medicine (Internal Medicine) Physician
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    License Number       |    032171
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    License Number State |    GA
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