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General NPI Number Information
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NPI Number | 1760657605
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Entity Type | Organization
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Legal Business Name | TROY MEDICAL CENTER MANAGEMENT
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Dates
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Enumeration Date | 04/22/2008
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Last Update Date | 04/22/2008
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Provider Practice Location Address
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Address Line | 1663 STEPHENSON HWY SUITE 100
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City | TROY
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State | MI
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Zip | 48083-2169
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Country | US
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Telephone | 248-689-7100
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Fax | 248-689-5571
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Provider Business Mailing Address
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Address Line | 1663 STEPHENSON HWY SUITE 100
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City | TROY
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State | MI
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Zip | 48083-2169
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Country | US
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Telephone | 248-689-7100
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Fax | 248-689-5571
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ABELARDO G. CONTRERAS
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Credential | M.D.
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Telephone | 248-689-7100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State | MI
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