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General NPI Number Information
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NPI Number | 1801110010
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Entity Type | Individual
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Provider Name | JASON BONEY MD
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Gender | Male
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Dates
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Enumeration Date | 03/16/2010
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Last Update Date | 08/11/2011
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Provider Practice Location Address
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Address Line | 36 KIMBALL BEACH RD
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City | HINGHAM
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State | MA
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Zip | 02043-1146
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Country | US
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Telephone | 617-500-4097
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Fax |
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Provider Business Mailing Address
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Address Line | 530 NANTASKET AVE APT 306
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City | HULL
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State | MA
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Zip | 02045-2557
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Country | US
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Telephone |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 01130415
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License Number State | MA
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