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General NPI Number Information
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NPI Number | 1821048513
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Entity Type | Individual
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Provider Name | SUHAIL I HAQUE MD
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Gender | Male
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 12/13/2024
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Provider Practice Location Address
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Address Line | 645 S ROY WILKINS AVE
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City | LOUISVILLE
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State | KY
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Zip | 40203-2072
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Country | US
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Telephone | 502-561-0520
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Fax | 502-561-0521
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Provider Business Mailing Address
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Address Line | 720 W BROADWAY STE 202
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City | LOUISVILLE
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State | KY
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Zip | 40202-3245
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Country | US
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Telephone | 502-561-0943
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Fax | 502-561-0944
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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 | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 35219
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | 01047434A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | 35219
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 35219
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License Number State | KY
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