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General NPI Number Information
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NPI Number | 1699161075
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Entity Type | Individual
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Provider Name | DENZIL DOUGLAS M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/13/2015
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Last Update Date | 11/07/2022
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Provider Practice Location Address
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Address Line | 501 KINGS HWY E STE 109
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City | FAIRFIELD
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State | CT
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Zip | 06825-4871
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Country | US
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Telephone | 203-330-0248
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 416173
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City | BOSTON
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State | MA
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Zip | 02241-6173
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Country | US
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Telephone | 610-644-8900
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Fax | 484-924-0053
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 301732
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License Number State | NY
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