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General NPI Number Information
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NPI Number | 1720036957
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Entity Type | Individual
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Provider Name | CYNTHIA LAWRENCE ELLIOTT M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 02/18/2011
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Provider Practice Location Address
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Address Line | 600 PROFESSIONAL DR SUITE 260
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City | LAWRENCEVILLE
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State | GA
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Zip | 30045-7651
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Country | US
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Telephone | 770-822-1090
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Fax | 770-513-9735
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Provider Business Mailing Address
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Address Line | 600 PROFESSIONAL DR SUITE 260
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-8719
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Country | US
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Telephone | 770-822-1090
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Fax | 770-513-9735
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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 | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 025997
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License Number State | GA
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