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General NPI Number Information
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NPI Number | 1467685073
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Entity Type | Individual
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Provider Name | KOMAL BHARATH MD
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Gender | Female
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Dates
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Enumeration Date | 08/30/2009
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Last Update Date | 08/14/2020
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Provider Practice Location Address
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Address Line | 333 COTTMAN AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19111-2434
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Country | US
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Telephone | 215-728-2844
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Fax | 215-214-1425
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Provider Business Mailing Address
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Address Line | 1601 CHESTNUT ST 2 LIBERTY PLACE
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City | PHILADELPHIA
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State | PA
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Zip | 19192-0001
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Country | US
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Telephone | 267-838-2061
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | MD443523
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD443523
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License Number State | PA
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