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General NPI Number Information
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NPI Number | 1710382296
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Entity Type | Organization
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Legal Business Name | MICHAEL BASKIN MD LLC
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Dates
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Enumeration Date | 10/27/2014
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Last Update Date | 01/02/2015
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Provider Practice Location Address
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Address Line | 4166 SW GREENLEAF DR
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City | PORTLAND
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State | OR
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Zip | 97221-3225
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Country | US
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Telephone | 503-887-6701
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Fax |
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Provider Business Mailing Address
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Address Line | 4166 SW GREENLEAF DR
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City | PORTLAND
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State | OR
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Zip | 97221-3225
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Country | US
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Telephone | 503-887-6701
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL S BASKIN
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Credential | MD
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Telephone | 503-887-6701
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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