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General NPI Number Information
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NPI Number | 1548129109
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Entity Type | Organization
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Legal Business Name | AEGIS ENDOSCOPY LLC
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Dates
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Enumeration Date | 01/20/2026
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Last Update Date | 02/06/2026
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Provider Practice Location Address
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Address Line | 935 BUFORD RD STE 101
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City | CUMMING
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State | GA
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Zip | 30041-3222
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Country | US
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Telephone | 678-528-0566
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Fax | 678-439-0865
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Provider Business Mailing Address
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Address Line | 3390 PADDOCKS PKWY STE 101
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City | SUWANEE
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State | GA
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Zip | 30024-9119
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Country | US
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Telephone | 770-400-0828
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Fax | 866-554-1774
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Authorized Official
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Title or Position | OWNER
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Name | DR. SUMANA MOOLE
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Credential | MD
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Telephone | 770-400-0828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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