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General NPI Number Information
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NPI Number | 1437111812
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Entity Type | Individual
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Provider Name | JEFFREY DAVID MANSER MD
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Gender | Male
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Dates
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Enumeration Date | 04/03/2006
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 1150 W LOCUST ST
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City | WILMINGTON
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State | OH
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Zip | 45177-2572
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Country | US
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Telephone | 937-535-7878
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Fax | 513-487-4849
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Provider Business Mailing Address
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Address Line | 1150 W LOCUST ST
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City | WILMINGTON
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State | OH
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Zip | 45177-2572
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Country | US
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Telephone | 937-535-7878
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Fax | 513-487-4849
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 35055578
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License Number State | OH
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