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General NPI Number Information
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NPI Number | 1790714368
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Entity Type | Individual
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Provider Name | HASSAN MONFARED MD
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Gender | Male
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Dates
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Enumeration Date | 07/03/2006
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 1365 CLIFTON RD NE
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City | ATLANTA
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State | GA
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Zip | 30322-1013
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Country | US
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Telephone | 404-712-2000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 55310
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City | BIRMINGHAM
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State | AL
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Zip | 35255-5310
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Country | US
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Telephone | 205-731-9701
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Fax |
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 25816
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 063881
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License Number State | GA
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