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General NPI Number Information
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NPI Number | 1710975271
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Entity Type | Individual
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Provider Name | THOMAS J CESARZ MD
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Gender | Male
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Dates
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Enumeration Date | 10/10/2005
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Last Update Date | 12/07/2007
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Provider Practice Location Address
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Address Line | 2300 N MAYFAIR RD #1155
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City | WAUWATOSA
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State | WI
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Zip | 53226-1505
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Country | US
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Telephone | 414-258-6880
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Fax | 414-258-5686
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Provider Business Mailing Address
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Address Line | 2300 N MAYFAIR RD #1155
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City | WAUWATOSA
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State | WI
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Zip | 53226-1505
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Country | US
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Telephone | 414-258-6880
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Fax | 414-258-5686
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 16007
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License Number State | WI
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