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NPI 1750475471

NPI 1750475471 : ALEXANDER MICHAEL LOCKE COTA/L : BALTIMORE, MD

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General NPI Number Information
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    NPI Number           |    1750475471
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    Entity Type          |    Individual 
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    Provider Name        |    ALEXANDER MICHAEL LOCKE COTA/L
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/03/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    3704 HUDSON STREET 
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    City                 |    BALTIMORE
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    State                |    MD
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    Zip                  |    21224
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    Country              |    US
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    Telephone            |    410-771-6868
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    Fax                  |    410-771-8444
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Provider Business Mailing Address
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    Address Line         |    3704 HUDSON STREET 
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    City                 |    BALTIMORE
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    State                |    MD
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    Zip                  |    21224
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    Country              |    US
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    Telephone            |    410-771-6868
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    Fax                  |    410-771-8444
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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        |    251E00000X
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    Taxonomy Name        |    Home Health Agency
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    License Number       |    A00503
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    License Number State |    MD
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