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General NPI Number Information
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NPI Number | 1457536336
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Entity Type | Organization
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Legal Business Name | CARDIOTHORACIC SURGERY, P.C.
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Dates
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Enumeration Date | 01/09/2008
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Last Update Date | 01/09/2008
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Provider Practice Location Address
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Address Line | 707 N MICHIGAN ST SUITE 501
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City | SOUTH BEND
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State | IN
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Zip | 46601-1067
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Country | US
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Telephone | 574-237-0644
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Fax | 574-234-6986
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Provider Business Mailing Address
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Address Line | 707 N MICHIGAN ST SUITE 501
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City | SOUTH BEND
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State | IN
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Zip | 46601-1067
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Country | US
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Telephone | 574-237-0644
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Fax | 574-234-6986
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MRS. TAMMY K ALBRIGHT
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Credential |
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Telephone | 574-237-0644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 01037310
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License Number State | IN
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