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General NPI Number Information
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NPI Number | 1457506248
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Entity Type | Individual
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Provider Name | ERWIN SUMILLER ATILLO MSN - CRNA
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Gender | Male
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Dates
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Enumeration Date | 11/21/2008
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Last Update Date | 03/14/2017
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Provider Practice Location Address
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Address Line | 5855 BREMO ROAD SUITE 100 N.
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City | RICHMOND
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State | VA
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Zip | 23226
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Country | US
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Telephone | 804-288-6258
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Fax |
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Provider Business Mailing Address
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Address Line | 6353A LOUDON AVE
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City | ELKRIDGE
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State | MD
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Zip | 21075-5636
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Country | US
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Telephone | 240-841-9038
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Fax |
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | R160082
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License Number State | MD
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