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General NPI Number Information
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NPI Number | 1720489370
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Entity Type | Organization
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Legal Business Name | ANNISTON DIGESTIVE HEALTH PC
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Dates
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Enumeration Date | 09/12/2014
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Last Update Date | 09/08/2015
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Provider Practice Location Address
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Address Line | 901 LEIGHTON AVE SUITE 103
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City | ANNISTON
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State | AL
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Zip | 36207-5700
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Country | US
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Telephone | 256-237-1001
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Fax | 256-237-0016
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Provider Business Mailing Address
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Address Line | 901 LEIGHTON AVE SUITE 103
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City | ANNISTON
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State | AL
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Zip | 36207-5700
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Country | US
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Telephone | 256-237-1001
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Fax | 256-237-0016
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Authorized Official
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Title or Position | MD/OWNER
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Name | MOHAMAD A ELOUBEIDI
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Credential | MD
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Telephone | 256-237-1001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 23315
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License Number State | AL
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