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General NPI Number Information
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NPI Number | 1619957370
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Entity Type | Individual
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Provider Name | BRUCE BIELFELT MD
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Gender | Male
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Dates
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Enumeration Date | 01/19/2006
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Last Update Date | 08/03/2009
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Provider Practice Location Address
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Address Line | 4300 N ACCESS RD SUITE D
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City | CHATTANOOGA
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State | TN
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Zip | 37415-3812
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Country | US
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Telephone | 423-826-1276
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Fax |
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Provider Business Mailing Address
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Address Line | 21298 OLEAN BLVD
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-6705
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Country | US
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Telephone | 941-624-7032
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Fax |
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | OS5642
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License Number State | FL
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