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General NPI Number Information
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NPI Number | 1518107903
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Entity Type | Organization
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Legal Business Name | REHABIT SMARTCENTER, LLC
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Dates
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Enumeration Date | 02/25/2009
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Last Update Date | 02/25/2009
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Provider Practice Location Address
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Address Line | 12150 ANNAPOLIS RD SUITE 211
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City | GLENN DALE
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State | MD
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Zip | 20769-9179
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Country | US
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Telephone | 240-245-4211
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Fax | 240-245-4212
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Provider Business Mailing Address
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Address Line | 2814 HATBORO PL
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City | UPPER MARLBORO
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State | MD
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Zip | 20774-9400
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Country | US
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Telephone | 301-537-7862
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Fax | 240-245-4212
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. VAUL A. PHILLIPS
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Credential | M.D.
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Telephone | 301-537-7862
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081N0008X
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Taxonomy Name | Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | D0046476
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License Number State | MD
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