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General NPI Number Information
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NPI Number | 1750472908
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Entity Type | Individual
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Provider Name | YVROSE VALCOURT MD
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Gender | Female
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 04/28/2008
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Provider Practice Location Address
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Address Line | 124 MEDICAL PARK DR
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City | WALTERBORO
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State | SC
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Zip | 29488-5719
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Country | US
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Telephone | 843-782-3636
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Fax | 843-782-3269
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Provider Business Mailing Address
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Address Line | 124 MEDICAL PARK DR
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City | WALTERBORO
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State | SC
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Zip | 29488-5719
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Country | US
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Telephone | 843-782-3636
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Fax | 843-782-3269
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 29352
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 058526
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License Number State | GA
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