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General NPI Number Information
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NPI Number | 1780985283
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Entity Type | Organization
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Legal Business Name | SEED FUND
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Dates
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Enumeration Date | 11/15/2010
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Last Update Date | 05/07/2015
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Provider Practice Location Address
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Address Line | 11215 APPALOOSA DR
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City | REISTERSTOWN
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State | MD
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Zip | 21136-6483
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Country | US
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Telephone | 410-526-7617
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Fax |
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Provider Business Mailing Address
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Address Line | 11215 APPALOOSA DR
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City | REISTERSTOWN
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State | MD
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Zip | 21136-6483
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Country | US
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Telephone | 410-526-7617
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Fax | 410-848-2644
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | SHARON TAYLOR
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Credential | M.D.
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Telephone | 410-526-7617
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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 | D0051072
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License Number State | MD
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