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General NPI Number Information
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NPI Number | 1447457817
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Entity Type | Individual
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Provider Name | PAUL I SUJI OD
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Gender | Male
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Dates
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Enumeration Date | 06/29/2007
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Last Update Date | 01/04/2013
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Provider Practice Location Address
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Address Line | 3393 PEACHTREE RD NE SUITE B 128
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City | ATLANTA
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State | GA
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Zip | 30326-1162
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Country | US
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Telephone | 404-233-9296
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Fax | 404-841-9908
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Provider Business Mailing Address
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Address Line | 3071 WOODWALK DR SE
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City | ATLANTA
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State | GA
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Zip | 30339-8551
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Country | US
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Telephone | 404-233-9296
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Fax | 404-841-9908
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 002386
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License Number State | GA
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