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General NPI Number Information
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NPI Number | 1558501619
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Entity Type | Organization
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Legal Business Name | TAYLOR DRUG REHAB CENTER PC
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Dates
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Enumeration Date | 03/03/2009
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Last Update Date | 03/03/2009
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Provider Practice Location Address
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Address Line | 7700 TELEGRAPH RD
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City | TAYLOR
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State | MI
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Zip | 48180-2236
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Country | US
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Telephone | 313-366-4500
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Fax |
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Provider Business Mailing Address
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Address Line | 7700 TELEGRAPH RD
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City | TAYLOR
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State | MI
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Zip | 48180-2236
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Country | US
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Telephone | 313-366-4500
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | DR. ASOK ROY
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Credential | M.D.
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Telephone | 313-366-4500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301031786
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 4301031786
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 4301031786
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number | 4301031786
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License Number State | MI
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