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General NPI Number Information
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NPI Number | 1831627843
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Entity Type | Individual
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Provider Name | SANJAY JUMANI MD
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Gender | Male
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Dates
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Enumeration Date | 06/03/2017
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 10 CENTER DR
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City | BETHESDA
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State | MD
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Zip | 20892-1465
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Country | US
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Telephone | 301-496-1211
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Fax |
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Provider Business Mailing Address
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Address Line | 180 HARVESTER DR STE 110
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City | BURR RIDGE
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State | IL
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Zip | 60527-6686
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Country | US
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Telephone | 773-702-1150
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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 | 125070562
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD210001428
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License Number State | DC
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