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General NPI Number Information
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NPI Number | 1649413238
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Entity Type | Organization
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Legal Business Name | PROGRESSIVE MEDICAL CENTER, PC
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Dates
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Enumeration Date | 04/12/2009
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Last Update Date | 04/12/2009
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Provider Practice Location Address
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Address Line | 4646 N SHALLOWFORD RD #500
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City | ATLANTA
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State | GA
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Zip | 30338-6308
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Country | US
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Telephone | 770-676-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 4646 N SHALLOWFORD RD #500
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City | ATLANTA
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State | GA
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Zip | 30338-6308
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Country | US
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Telephone | 770-676-6000
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. FRANK PAUL MATALONE
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Credential | D.O.
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Telephone | 770-676-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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