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General NPI Number Information
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NPI Number | 1588612147
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Entity Type | Individual
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Provider Name | SUSAN M VICENTI MD
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Gender | Female
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Dates
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Enumeration Date | 05/05/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 40 AULIKE ST SUITE 410
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City | KAILUA
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State | HI
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Zip | 96734-2758
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Country | US
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Telephone | 808-261-3000
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Fax | 808-261-3303
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Provider Business Mailing Address
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Address Line | 40 AULIKE ST SUITE 410
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City | KAILUA
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State | HI
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Zip | 96734-2758
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Country | US
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Telephone | 808-261-3000
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Fax | 808-261-3303
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 7824
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License Number State | HI
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