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General NPI Number Information
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NPI Number | 1699749218
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Entity Type | Individual
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Provider Name | VINCENT MYSLIWIEC M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | DEPARTMENT OF PULMONARY MEDICINE: MAMC 9040 FITZSIMMONS AVE
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City | TACOMA
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State | WA
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Zip | 98431-0001
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Country | US
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Telephone | 253-968-2103
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Fax | 253-968-2284
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Provider Business Mailing Address
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Address Line | 41 LESCHI DR
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City | STEILACOOM
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State | WA
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Zip | 98388-1513
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Country | US
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Telephone | 253-968-2103
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Fax | 253-968-2284
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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 | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 10206
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License Number State | HI
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