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General NPI Number Information
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NPI Number | 1629335195
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Entity Type | Organization
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Legal Business Name | R.R. YALAMANCHI, M.D. P.C.
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Dates
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Enumeration Date | 04/20/2012
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Last Update Date | 04/20/2012
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Provider Practice Location Address
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Address Line | 13300 NORTHLINE RD
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City | SOUTHGATE
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State | MI
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Zip | 48195-1065
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Country | US
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Telephone | 734-282-7353
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Fax | 734-282-8178
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Provider Business Mailing Address
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Address Line | 13300 NORTHLINE RD
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City | SOUTHGATE
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State | MI
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Zip | 48195-1065
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Country | US
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Telephone | 734-282-7353
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Fax | 734-282-8178
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Authorized Official
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Title or Position | OWNER
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Name | DR. R R YALAMANCHI
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Credential | M.D.
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Telephone | 734-282-7353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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