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General NPI Number Information
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NPI Number | 1710965934
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Entity Type | Individual
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Provider Name | CHARLOTTE H SMITH MD
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Gender | Female
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Dates
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Enumeration Date | 01/06/2006
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Last Update Date | 09/07/2022
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Provider Practice Location Address
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Address Line | 11490 GATEWAY BLVD N
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City | EL PASO
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State | TX
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Zip | 79934-3456
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Country | US
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Telephone | 888-380-0988
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Fax | 289-236-3022
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Provider Business Mailing Address
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Address Line | 2950 BUSKIRK AVE STE 300
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City | WALNUT CREEK
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State | CA
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Zip | 94597-6900
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Country | US
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Telephone | 888-380-0988
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Fax | 289-236-3022
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | MD60279166
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 2081P0004X
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Taxonomy Name | Spinal Cord Injury Medicine Physician
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License Number | H2465
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 2081P0301X
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Taxonomy Name | Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | H2465
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | H2465
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License Number State | TX
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