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General NPI Number Information
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NPI Number | 1639594344
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Entity Type | Organization
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Legal Business Name | ONEMD ST MATTHEWS PLLC
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Dates
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Enumeration Date | 03/04/2014
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Last Update Date | 03/04/2014
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Provider Practice Location Address
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Address Line | 112 SEARS AVE
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City | LOUISVILLE
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State | KY
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Zip | 40207-5014
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Country | US
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Telephone | 502-238-2163
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Fax | 502-238-2173
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Provider Business Mailing Address
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Address Line | 2425 LIME KILN LN
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City | LOUISVILLE
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State | KY
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Zip | 40222-3462
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Country | US
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Telephone | 502-899-7163
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Fax | 502-897-9963
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Authorized Official
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Title or Position | PARTNER
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Name | DR. JOHN VARGA
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Credential | M.D.
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Telephone | 502-899-7163
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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 | 34957
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License Number State | KY
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