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General NPI Number Information
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NPI Number | 1770694937
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Entity Type | Individual
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Provider Name | PAMELA LUCILLE STEVENS MD
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Gender | Female
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 02/11/2019
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Provider Practice Location Address
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Address Line | 350 ALBERTA DR STE 107
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City | AMHERST
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State | NY
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Zip | 14226-1855
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Country | US
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Telephone | 716-689-1113
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Fax |
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Provider Business Mailing Address
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Address Line | 1360 N FOREST RD STE 5
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221
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Country | US
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Telephone | 716-689-1113
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Fax | 716-689-0335
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 175900
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License Number State | NY
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