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General NPI Number Information
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NPI Number | 1518373737
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Entity Type | Individual
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Provider Name | KAMEL MUNTHER MASSARWEH MBBS
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Gender | Male
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Dates
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Enumeration Date | 07/08/2014
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Last Update Date | 07/07/2022
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Provider Practice Location Address
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Address Line | 841 MAIN ST APT C
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City | BELLEVILLE
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State | NJ
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Zip | 07109-3435
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Country | US
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Telephone | 201-693-2338
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Fax |
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Provider Business Mailing Address
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Address Line | 10450 LILAC LN APT 1125
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City | FORT WAYNE
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State | IN
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Zip | 46825-2788
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Country | US
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Telephone | 201-693-2338
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 01077948
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 01077948A
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License Number State | IN
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