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General NPI Number Information
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NPI Number | 1750598470
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Entity Type | Individual
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Provider Name | REZA IZADI D,O.
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Gender | Male
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 06/07/2013
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Provider Practice Location Address
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Address Line | 1150 VARNUM ST NE DEPARTMENT OF ANESTHESIOLOGY
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City | WASHINGTON
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State | DC
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Zip | 20017-2104
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Country | US
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Telephone | 914-582-5909
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Fax |
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Provider Business Mailing Address
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Address Line | 3117 DEVONSHIRE DR
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City | PLANO
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State | TX
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Zip | 75075-3374
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Country | US
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Telephone | 914-582-5909
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Fax | 888-394-0177
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 244086
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | N1689
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License Number State | TX
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