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General NPI Number Information
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NPI Number | 1477708154
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Entity Type | Individual
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Provider Name | MEGAN EDMONSOND MD
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Gender | Female
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Dates
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Enumeration Date | 11/23/2008
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Last Update Date | 08/17/2010
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Provider Practice Location Address
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Address Line | 27865 CLEMENS RD
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City | WESTLAKE
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State | OH
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Zip | 44145-1167
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Country | US
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Telephone | 713-907-8402
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Fax |
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Provider Business Mailing Address
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Address Line | 5438 KINGLET ST
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City | HOUSTON
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State | TX
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Zip | 77096-5015
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Country | US
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Telephone | 713-907-8402
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 30366
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License Number State | AL
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