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General NPI Number Information
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NPI Number | 1699875468
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Entity Type | Individual
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Provider Name | KIMBERLY A ROSSI MD
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Gender | Female
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3100 MACCORKLE AVE SUITE201
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City | CHARLESTON
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State | WV
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Zip | 25304-1223
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Country | US
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Telephone | 304-342-3360
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Fax | 304-342-3363
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Provider Business Mailing Address
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Address Line | 2617 VIRGINIA AVENUE
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City | CHARLESTON
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State | WV
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Zip | 25304
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Country | US
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Telephone | 304-881-2600
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Fax | 304-342-3363
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 20839
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License Number State | WV
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