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General NPI Number Information
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NPI Number | 1447580535
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Entity Type | Individual
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Provider Name | SHELLEY RAE MAIER P.A.-C
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Gender | Female
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Dates
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Enumeration Date | 01/12/2010
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Last Update Date | 01/12/2010
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Provider Practice Location Address
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Address Line | 3130 N DIXIE HWY SUITE 203
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City | TROY
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State | OH
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Zip | 45373-1337
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Country | US
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Telephone | 937-339-7982
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Fax | 937-339-7842
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Provider Business Mailing Address
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Address Line | 3130 N DIXIE HWY SUITE 203
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City | TROY
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State | OH
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Zip | 45373-1337
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Country | US
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Telephone | 937-339-7982
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Fax | 937-339-7842
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 50.001420
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License Number State | OH
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