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General NPI Number Information
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NPI Number | 1477563740
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Entity Type | Individual
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Provider Name | MICHAEL DAVID MARTZ DO
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Gender | Male
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 07/06/2017
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Provider Practice Location Address
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Address Line | 825 W MARKET ST SUITE 205
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City | LIMA
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State | OH
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Zip | 45805-2799
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Country | US
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Telephone | 419-996-5780
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Fax | 419-996-5781
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Provider Business Mailing Address
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Address Line | PO BOX 636930
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City | CINCINNATI
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State | OH
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Zip | 45263-0001
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Country | US
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Telephone | 513-981-5015
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 34.008817
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License Number State | OH
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