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General NPI Number Information
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NPI Number | 1699754754
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Entity Type | Individual
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Provider Name | PAUL D CROISSANT M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/17/2006
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Last Update Date | 03/24/2020
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Provider Practice Location Address
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Address Line | 44555 WOODWARD AVE STE 307
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City | PONTIAC
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State | MI
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Zip | 48341-5035
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Country | US
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Telephone | 248-484-5303
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Fax | 488-585-8692
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Provider Business Mailing Address
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Address Line | 44555 WOODWARD AVE STE 307
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City | PONTIAC
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State | MI
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Zip | 48341-5035
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Country | US
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Telephone | 248-484-5303
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Fax | 488-585-8692
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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 | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | 4301029245
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License Number State | MI
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