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General NPI Number Information
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NPI Number | 1417203126
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Entity Type | Individual
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Provider Name | MARK SILVIO PEDRI D.O. M.P.H.
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Gender | Male
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Dates
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Enumeration Date | 07/31/2012
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Last Update Date | 03/29/2017
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Provider Practice Location Address
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Address Line | 130 KAMEHAMEHA V HIGHWAY
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City | KAUNAKAKAI
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State | HI
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Zip | 96748-1234
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Country | US
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Telephone | 808-658-6930
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Fax | 808-633-8535
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Provider Business Mailing Address
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Address Line | PO BOX 1234
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City | KAUNAKAKAI
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State | HI
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Zip | 96748-1234
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Country | US
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Telephone | 808-658-6930
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Fax | 808-633-8535
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | DOS-1564
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | OP 60428780
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License Number State | WA
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