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General NPI Number Information
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NPI Number | 1598435059
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Entity Type | Organization
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Legal Business Name | CRH MD MANAGEMENT LLC
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Dates
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Enumeration Date | 09/16/2021
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Last Update Date | 12/17/2021
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Provider Practice Location Address
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Address Line | 11804 REISTERSTOWN RD
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City | REISTERSTOWN
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State | MD
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Zip | 21136-3311
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Country | US
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Telephone | 410-870-5094
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Fax | 410-870-8076
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Provider Business Mailing Address
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Address Line | 2675 PACES FERRY RD SE STE 200
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City | ATLANTA
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State | GA
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Zip | 30339-4099
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Country | US
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Telephone | 678-504-6392
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANDREA MALIK ROE
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Credential |
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Telephone | 678-504-6392
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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