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General NPI Number Information
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NPI Number | 1730941162
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Entity Type | Organization
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Legal Business Name | METABOLIC SYNDROME INSULIN INFUSION - STAFFORD LLC
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Dates
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Enumeration Date | 01/30/2024
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Last Update Date | 01/30/2024
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Provider Practice Location Address
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Address Line | 450 GARRISONVILLE RD STE 202
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City | STAFFORD
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State | VA
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Zip | 22554-1615
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Country | US
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Telephone | 240-888-8292
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Fax |
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Provider Business Mailing Address
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Address Line | 147 HERON POINTE DR
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City | CAPE CHARLES
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State | VA
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Zip | 23310-2398
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Country | US
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Telephone | 240-888-8292
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | DONALD MARETTE
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Credential |
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Telephone | 240-888-8292
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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