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General NPI Number Information
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NPI Number | 1477752376
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Entity Type | Organization
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Legal Business Name | MUFTAH A. KADURA, MD
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Dates
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Enumeration Date | 07/12/2007
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Last Update Date | 06/18/2008
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Provider Practice Location Address
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Address Line | 235 GENESEE ST
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City | WAMPSVILLE
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State | NY
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Zip | 13163
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Country | US
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Telephone | 315-363-1363
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Fax | 315-363-6889
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Provider Business Mailing Address
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Address Line | 235 GENESEE ST
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City | WAMPSVILLE
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State | NY
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Zip | 13163
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Country | US
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Telephone | 315-363-1363
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Fax | 315-363-6889
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Authorized Official
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Title or Position | OWNER/ PRESIDENT
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Name | MUFTAH A. KADURA
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Credential | M.D.
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Telephone | 315-245-0505
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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 | 204779
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License Number State | NY
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