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General NPI Number Information
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NPI Number | 1770531386
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Entity Type | Individual
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Provider Name | GLENN ANDREW HEALEY MD
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Gender | Male
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Dates
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Enumeration Date | 05/05/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 361 OLD BELGRADE RD
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City | AUGUSTA
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State | ME
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Zip | 04330-8058
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Country | US
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Telephone | 207-621-9400
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Fax | 207-621-9402
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Provider Business Mailing Address
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Address Line | PO BOX 689
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City | BOALSBURG
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State | PA
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Zip | 16827-0689
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Country | US
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Telephone | 814-237-8627
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Fax | 814-238-0083
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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 | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 015031
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License Number State | ME
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