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General NPI Number Information
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NPI Number | 1508815036
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Entity Type | Individual
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Provider Name | ROMEO ANTON PAVLIC MD
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Gender | Male
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Dates
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Enumeration Date | 05/10/2006
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Last Update Date | 07/12/2021
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Provider Practice Location Address
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Address Line | 140 S ARTHUR ST STE 408
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City | SPOKANE
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State | WA
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Zip | 99202-2220
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Country | US
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Telephone | 509-557-7776
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Fax | 509-838-9683
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Provider Business Mailing Address
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Address Line | PO BOX 637
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City | SPOKANE
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State | WA
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Zip | 99210-0637
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Country | US
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Telephone | 509-557-7776
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Fax | 509-838-9683
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | M4759
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 00018454
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License Number State | WA
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