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General NPI Number Information
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NPI Number | 1679520720
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Entity Type | Organization
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Legal Business Name | CRITICAL CARE MANAGEMENT GROUP, LLC
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Dates
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Enumeration Date | 05/27/2006
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Last Update Date | 10/06/2009
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Provider Practice Location Address
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Address Line | 3533 DUNN RD SUITE 210
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City | FLORISSANT
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State | MO
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Zip | 63033-6761
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Country | US
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Telephone | 314-921-2250
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Fax |
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Provider Business Mailing Address
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Address Line | 3533 DUNN RD SUITE 210
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City | FLORISSANT
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State | MO
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Zip | 63033-6761
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Country | US
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Telephone | 314-921-2250
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROBERT J SIMPSON
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Credential | DO
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Telephone | 314-921-2250
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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