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General NPI Number Information
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NPI Number | 1427202670
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Entity Type | Individual
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Provider Name | JOSE LUIS CHAVEZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/13/2008
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Last Update Date | 11/13/2008
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Provider Practice Location Address
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Address Line | 3380 ERIE AVE SUITE 100
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City | CINCINNATI
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State | OH
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Zip | 45208-1626
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Country | US
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Telephone | 513-533-2835
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Fax | 513-533-2843
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Provider Business Mailing Address
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Address Line | 3380 ERIE AVE SUITE 100
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City | CINCINNATI
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State | OH
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Zip | 45208-1626
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Country | US
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Telephone | 513-533-2835
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Fax | 513-533-2843
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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 | 35-043909
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License Number State | OH
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