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General NPI Number Information
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NPI Number | 1508105545
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Entity Type | Individual
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Provider Name | FIDEL DESIR MD, PHD
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Gender | Male
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Dates
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Enumeration Date | 02/12/2013
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Last Update Date | 06/22/2023
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Provider Practice Location Address
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Address Line | 1600 CLIFTON RD NE
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City | ATLANTA
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State | GA
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Zip | 30329-4018
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Country | US
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Telephone | 404-498-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 CLIFTON RD NE
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City | ATLANTA
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State | GA
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Zip | 30329-4018
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Country | US
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Telephone |
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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 | 261QP0904X
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Taxonomy Name | Federal Public Health Clinic/Center
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License Number |
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License Number State |
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