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General NPI Number Information
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NPI Number | 1578755203
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Entity Type | Organization
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Legal Business Name | MICHAEL W STAVINOHA MD PA
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Dates
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Enumeration Date | 08/16/2007
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Last Update Date | 01/14/2011
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Provider Practice Location Address
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Address Line | 1631 NORTH LOOP WEST SUITE 655
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City | HOUSTON
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State | TX
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Zip | 77008
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Country | US
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Telephone | 713-869-8200
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Fax | 713-867-2013
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Provider Business Mailing Address
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Address Line | 1631 NORTH LOOP WEST SUITE 655
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City | HOUSTON
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State | TX
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Zip | 77008
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Country | US
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Telephone | 713-869-8200
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Fax | 713-867-2013
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Authorized Official
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Title or Position | PHYSICIAN
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Name | MICHAEL W STAVINOHA
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Credential | M D P A
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Telephone | 713-869-8200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | G8436
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License Number State | TX
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