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General NPI Number Information
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NPI Number | 1780677484
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Entity Type | Individual
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Provider Name | RACHEL E KALTER D.O.
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Gender | Female
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Dates
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Enumeration Date | 08/26/2005
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Last Update Date | 03/30/2018
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Provider Practice Location Address
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Address Line | 770 INDIAN BOUNDARY RD STE 200
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City | CHESTERTON
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State | IN
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Zip | 46304-1519
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Country | US
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Telephone | 219-872-6566
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Fax | 219-395-8077
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Provider Business Mailing Address
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Address Line | 2025 W OKLAHOMA AVE SUITE 124
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City | MILWAUKEE
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State | WI
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Zip | 53215-4455
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Country | US
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Telephone | 414-672-5250
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Fax | 414-672-2290
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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 | 40064
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License Number State | WI
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