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General NPI Number Information
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NPI Number | 1679962716
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Entity Type | Organization
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Legal Business Name | FAMILY CENTERED MIDWIFERY CARE, LLC
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Dates
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Enumeration Date | 01/13/2015
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Last Update Date | 01/13/2015
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Provider Practice Location Address
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Address Line | 2719 FELTON DR SUITE A
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City | EAST POINT
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State | GA
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Zip | 30344-3603
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Country | US
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Telephone | 404-349-2112
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Fax | 404-767-6553
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Provider Business Mailing Address
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Address Line | 2719 FELTON DR SUITE A
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City | EAST POINT
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State | GA
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Zip | 30344-3603
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Country | US
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Telephone | 404-349-2112
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Fax | 404-767-6553
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Authorized Official
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Title or Position | CEO
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Name | MS. MARSHA D FORD
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Credential | CNM
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Telephone | 404-349-2112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | RN066207
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License Number State | GA
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