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General NPI Number Information
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NPI Number | 1588630859
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Entity Type | Individual
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Provider Name | FAE G NASON MD
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Gender | Female
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Dates
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Enumeration Date | 02/27/2006
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Last Update Date | 04/23/2020
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Provider Practice Location Address
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Address Line | 123 SUMMER ST
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City | WORCESTER
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State | MA
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Zip | 01608-1216
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Country | US
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Telephone | 508-368-3110
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Fax | 508-968-3113
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Provider Business Mailing Address
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Address Line | 5 NEPONSET ST WOT 2ND FL, STE C203
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City | WORCESTER
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State | MA
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Zip | 01606-2714
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Country | US
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Telephone | 508-368-3110
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Fax | 508-368-3113
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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 | 76444
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License Number State | MA
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