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General NPI Number Information
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NPI Number | 1528049053
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Entity Type | Individual
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Provider Name | EVELYN R MOTE M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/10/2005
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 3033 KETTERING BLVD STE 100
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City | MORAINE
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State | OH
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Zip | 45439-1948
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Country | US
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Telephone | 937-293-2133
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Fax | 855-252-2435
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Provider Business Mailing Address
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Address Line | PO BOX 639295 DEPT 93394
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City | CINCINNATI
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State | OH
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Zip | 45263-9295
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Country | US
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Telephone | 937-293-2133
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Fax | 855-252-2435
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35062357
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License Number State | OH
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