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General NPI Number Information
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NPI Number | 1699096750
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Entity Type | Individual
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Provider Name | KEVIN CORMIER MD
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Gender | Male
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Dates
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Enumeration Date | 06/11/2010
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Last Update Date | 04/05/2016
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Provider Practice Location Address
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Address Line | 3990 E US 64 ALT
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City | MURPHY
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State | NC
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Zip | 28906-6843
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Country | US
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Telephone | 423-778-7234
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Fax | 423-778-6261
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Provider Business Mailing Address
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Address Line | 2401 GILLHAM RD
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City | KANSAS CITY
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State | MO
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Zip | 64108-4619
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Country | US
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Telephone | 337-517-3999
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD.207233
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License Number State | LA
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