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General NPI Number Information
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NPI Number | 1528164746
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Entity Type | Individual
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Provider Name | CHARLES MUNCRIEF D.O.
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Gender | Male
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Dates
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Enumeration Date | 09/15/2006
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Last Update Date | 04/10/2008
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Provider Practice Location Address
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Address Line | 90 VILLAGE POINTE DR
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City | POWELL
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State | OH
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Zip | 43065-7760
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Country | US
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Telephone | 614-791-1300
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Fax |
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Provider Business Mailing Address
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Address Line | 4817 AVONDALE RIDGE DR
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City | DUBLIN
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State | OH
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Zip | 43017-8623
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Country | US
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Telephone | 614-789-9345
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 34 007385
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License Number State | OH
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