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NPI 1699780569

NPI 1699780569 : ORRETH BRUCE CASE MD : ALPHARETTA, GA

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General NPI Number Information
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    NPI Number           |    1699780569
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    Entity Type          |    Individual 
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    Provider Name        |    ORRETH BRUCE CASE MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    07/29/2006
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    Last Update Date     |    08/08/2018
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Provider Practice Location Address
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    Address Line         |    5755 N POINT PKWY SUITE 98
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    City                 |    ALPHARETTA
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    State                |    GA
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    Zip                  |    30022
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    Country              |    US
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    Telephone            |    404-257-0644
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    Fax                  |    404-257-0644
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Provider Business Mailing Address
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    Address Line         |    5755 N POINT PKWY SUITE 98
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    City                 |    ALPHARETTA
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    State                |    GA
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    Zip                  |    30022-1142
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    Country              |    US
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    Telephone            |    404-257-0644
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    Fax                  |    404-257-0644
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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        |    208600000X
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    Taxonomy Name        |    Surgery Physician
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    License Number       |    045418
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    License Number State |    GA
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