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General NPI Number Information
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NPI Number | 1437439502
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Entity Type | Organization
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Legal Business Name | ST. JOHN HOSPITAL AND MEDICAL CENTER
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Dates
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Enumeration Date | 08/22/2011
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Last Update Date | 08/22/2011
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Provider Practice Location Address
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Address Line | 22151 MOROSS RD PB I SUITE 332
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City | DETROIT
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State | MI
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Zip | 48236-2167
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Country | US
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Telephone | 313-343-7849
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Fax |
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Provider Business Mailing Address
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Address Line | 21441 SLOAN DR APT. # 203 B
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City | HARPER WOODS
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State | MI
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Zip | 48225-2428
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | M.D.
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Name | ARMANDO JOSE SALAZAR
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Credential |
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Telephone | 305-613-1911
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | AS3062508-28
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License Number State | MI
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