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General NPI Number Information
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NPI Number | 1427093160
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Entity Type | Organization
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Legal Business Name | SCOTT PETERS DPM CWS LTD
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Dates
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Enumeration Date | 06/17/2006
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Last Update Date | 05/30/2008
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Provider Practice Location Address
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Address Line | 730 SOM CENTER RD
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City | MAYFIELD VILLAGE
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State | OH
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Zip | 44143-2350
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Country | US
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Telephone | 440-995-1111
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Fax | 440-995-1234
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Provider Business Mailing Address
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Address Line | 730 SOM CENTER RD
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City | MAYFIELD VILLAGE
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State | OH
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Zip | 44143-2362
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Country | US
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Telephone | 440-995-1111
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Fax | 440-995-1234
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Authorized Official
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Title or Position | OWNER
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Name | DR. SCOTT G PETERS
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Credential | DPM, CWS
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Telephone | 440-995-1111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 36003015P
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License Number State | OH
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