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General NPI Number Information
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NPI Number | 1770538555
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Entity Type | Organization
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Legal Business Name | GODFREY D ONIME MD PC
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Dates
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Enumeration Date | 05/23/2006
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Last Update Date | 06/07/2011
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Provider Practice Location Address
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Address Line | 4900 FAYETTEVILLE RD
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City | LUMBERTON
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State | NC
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Zip | 28358-2110
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Country | US
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Telephone | 910-739-8899
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Fax | 910-739-7174
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Provider Business Mailing Address
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Address Line | 4900 FAYETTEVILLE RD
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City | LUMBERTON
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State | NC
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Zip | 28358-2110
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Country | US
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Telephone | 910-739-8899
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Fax | 910-739-7174
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GODFREY D ONIME
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Credential | M.D.
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Telephone | 910-739-8899
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 200201138
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License Number State | NC
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