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General NPI Number Information
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NPI Number | 1558352419
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Entity Type | Individual
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Provider Name | JOHN MICHAEL SAMOL MD
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Gender | Male
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Dates
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Enumeration Date | 10/31/2005
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Last Update Date | 02/25/2009
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Provider Practice Location Address
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Address Line | 8245 NORTHCREEK DR
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City | CINCINNATI
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State | OH
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Zip | 45236-2283
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Country | US
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Telephone | 513-745-1706
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Fax | 513-891-2197
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Provider Business Mailing Address
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Address Line | 4600 WESLEY AVE STE. N
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City | CINCINNATI
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State | OH
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Zip | 45212-2298
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Country | US
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Telephone | 513-841-5220
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Fax | 513-841-1580
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 35083093S
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License Number State | OH
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