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General NPI Number Information
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NPI Number | 1578580569
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Entity Type | Individual
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Provider Name | DAVID CHARLES FORE M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 04/15/2022
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Provider Practice Location Address
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Address Line | 1 MED CENTER DR
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City | CLARKSBURG
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State | WV
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Zip | 26301-4155
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Country | US
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Telephone | 304-623-7674
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Fax |
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Provider Business Mailing Address
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Address Line | 24 MOLISEE RD
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City | MORGANTOWN
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State | WV
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Zip | 26508-3597
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Country | US
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Telephone | 304-291-0355
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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 | 21687
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License Number State | WV
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