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General NPI Number Information
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NPI Number | 1619542172
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Entity Type | Individual
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Provider Name | MARIA ANGELA MILAOR MATABANG M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/26/2021
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Last Update Date | 03/26/2026
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Provider Practice Location Address
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Address Line | 2771 SILVER CREEK RD STE 120
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City | BULLHEAD CITY
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State | AZ
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Zip | 86442-8023
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Country | US
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Telephone | 928-763-7722
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Fax | 928-763-7744
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Provider Business Mailing Address
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Address Line | 3333 E CAMELBACK RD STE 180
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City | PHOENIX
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State | AZ
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Zip | 85018-2396
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Country | US
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Telephone | 602-759-6883
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Fax | 602-224-3358
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 77922
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License Number State | AZ
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