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General NPI Number Information
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NPI Number | 1609069368
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Entity Type | Organization
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Legal Business Name | JAN DRLIK, MD, PLLC
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Dates
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Enumeration Date | 08/24/2007
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Last Update Date | 03/23/2012
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Provider Practice Location Address
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Address Line | 321 E HARRIS ST
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City | CHARLOTTE
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State | MI
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Zip | 48813-1629
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Country | US
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Telephone | 989-906-4208
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2580
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City | MIDLAND
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State | MI
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Zip | 48641-2580
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Country | US
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Telephone | 989-906-4208
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAN DRLIK
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Credential | MD
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Telephone | 989-906-4208
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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