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General NPI Number Information
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NPI Number | 1790760734
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Entity Type | Individual
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Provider Name | CRAIG H THAME M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/13/2005
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Last Update Date | 04/27/2012
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Provider Practice Location Address
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Address Line | 5352 LINTON BLVD ATTN: RADIOLOGY DEPT
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City | DELRAY BEACH
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State | FL
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Zip | 33484-6514
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Country | US
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Telephone | 561-498-4440
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1547
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City | INDIANAPOLIS
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State | IN
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Zip | 46206-1547
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Country | US
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Telephone | 877-440-0482
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Fax | 317-705-5060
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 25MA06149100
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 101490
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License Number State | FL
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