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General NPI Number Information
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NPI Number | 1437201902
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Entity Type | Organization
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Legal Business Name | SON - LU HOME CARE DOCTORS PC
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 05/28/2010
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Provider Practice Location Address
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Address Line | 24585 RIDGECROFT
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City | EASTPOINTE
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State | MI
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Zip | 48021
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Country | US
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Telephone | 586-876-7176
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Fax | 586-772-2585
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Provider Business Mailing Address
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Address Line | 24585 RIDGECROFT
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City | EASTPOINTE
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State | MI
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Zip | 48021
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Country | US
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Telephone | 586-876-7176
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Fax | 586-772-2585
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Authorized Official
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Title or Position | MEDICL DOCTOR
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Name | DR. ALPHONSE A EKOLE
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Credential | MD
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Telephone | 586-876-7176
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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