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General NPI Number Information
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NPI Number | 1578742722
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Entity Type | Organization
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Legal Business Name | THORACIC AND CARDIOVASCULAR ASSOCIATES
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Dates
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Enumeration Date | 10/24/2007
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Last Update Date | 12/07/2007
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Provider Practice Location Address
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Address Line | 75 ARCH ST SUITE 412
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City | AKRON
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State | OH
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Zip | 44304-1429
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Country | US
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Telephone | 330-762-0366
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Fax |
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Provider Business Mailing Address
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Address Line | 75 ARCH ST SUITE 412
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City | AKRON
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State | OH
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Zip | 44304-1429
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. KAREN ELAIINE MITCHEN
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Credential | RN
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Telephone | 330-762-0366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 36041
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License Number State | OH
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