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General NPI Number Information
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NPI Number | 1578302055
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Entity Type | Organization
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Legal Business Name | MEDSTAR MEDICAL GROUP II LLC
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Dates
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Enumeration Date | 05/23/2024
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Last Update Date | 07/26/2024
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Provider Practice Location Address
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Address Line | 3800 RESERVOIR RD NW
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City | WASHINGTON
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State | DC
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Zip | 20007
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Country | US
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Telephone | 703-558-1403
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 418597
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City | BOSTON
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State | MA
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Zip | 02241-8597
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Country | US
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Telephone | 703-558-1403
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Fax |
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Authorized Official
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Title or Position | VP
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Name | STEPHANIE SCHNEIDER
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Credential |
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Telephone | 703-558-1403
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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 |
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License Number State |
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