{
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"FirstLineMailingAddress": "PO BOX 790126",
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"FirstLinePracticeLocationAddress": "1185 W CARMEL DR STE D1A",
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"PracticeLocationAddressCityName": "CARMEL",
"PracticeLocationAddressStateName": "IN",
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"PracticeLocationAddressFaxNumber": "317-324-3950",
"EnumerationDate": "06/10/2013",
"LastUpdateDate": "03/04/2019",
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"NPIReactivationDate": null,
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"AuthorizedOfficialLastName": "HALUM",
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"AuthorizedOfficialCredential": "M.D.",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Otolaryngology Physician",
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}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}