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General NPI Number Information
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NPI Number | 1659551091
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Entity Type | Organization
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Legal Business Name | CORNERSTONE FAMILY PRACTICE, P.C.
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Dates
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Enumeration Date | 11/13/2007
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Last Update Date | 11/13/2007
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Provider Practice Location Address
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Address Line | 2098 TERON TRCE SUITE 400
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City | DACULA
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State | GA
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Zip | 30019-1663
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Country | US
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Telephone | 770-904-2112
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Fax | 678-546-3687
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Provider Business Mailing Address
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Address Line | 2098 TERON TRCE SUITE 400
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City | DACULA
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State | GA
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Zip | 30019-1663
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Country | US
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Telephone | 770-904-2112
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Fax | 678-546-3687
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Authorized Official
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Title or Position | OWNER
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Name | DR. VERONICA MICHELLE PATTERSON
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Credential | M.D.
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Telephone | 770-904-2112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 043107
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License Number State | GA
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