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General NPI Number Information
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NPI Number | 1508807439
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Entity Type | Individual
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Provider Name | THOMAS PILLA MD
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Gender | Male
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Dates
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Enumeration Date | 06/10/2006
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Last Update Date | 08/18/2011
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Provider Practice Location Address
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Address Line | 10 HOSPITAL DR
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City | SAINT PETERS
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State | MO
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Zip | 63376-1659
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Country | US
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Telephone | 636-916-9662
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Fax | 636-916-9659
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Provider Business Mailing Address
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Address Line | 660 S EUCLID AVE C B 8131
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City | SAINT LOUIS
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State | MO
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Zip | 63110-1010
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Country | US
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Telephone | 636-916-9662
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Fax | 636-916-9659
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | R1B87
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License Number State | MO
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