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General NPI Number Information
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NPI Number | 1720406705
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Entity Type | Individual
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Provider Name | STEPHANIE ROSE THOMAS MD (ANTIC. 5/16/14)
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Gender | Female
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Dates
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Enumeration Date | 04/07/2014
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Last Update Date | 01/07/2019
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Provider Practice Location Address
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Address Line | 2500 METROHEALTH DR
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City | CLEVELAND
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State | OH
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Zip | 44109-1998
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Country | US
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Telephone | 216-778-4486
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Fax |
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Provider Business Mailing Address
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Address Line | 833 CHESTNUT STREET 1ST FLOOR
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City | PHILADELPHIA
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State | PA
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Zip | 19107-4420
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Country | US
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Telephone | 215-955-5000
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Fax | 215-923-1089
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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 | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | MD465175
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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