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General NPI Number Information
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NPI Number | 1508926759
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Entity Type | Organization
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Legal Business Name | SUBURBAN HEMATOLOGY ONCOLOGY ASSOCIATES, PC
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 01/28/2010
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Provider Practice Location Address
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Address Line | 631 PROFESSIONAL DRIVE SUITE 450
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-7651
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Country | US
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Telephone | 770-963-8030
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Fax | 770-339-9577
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Provider Business Mailing Address
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Address Line | 631 PROFESSIONAL DRIVE SUITE 450
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-7650
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Country | US
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Telephone | 770-963-8030
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Fax | 770-339-9577
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. CANDACE A HAYES
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Credential |
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Telephone | 678-533-1555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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