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General NPI Number Information
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NPI Number | 1831699958
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Entity Type | Organization
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Legal Business Name | REGENERATIVE SPORTS MEDICINE INC
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Dates
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Enumeration Date | 02/15/2018
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 1462 MONTREAL RD STE 109
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City | TUCKER
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State | GA
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Zip | 30084-6904
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Country | US
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Telephone | 678-257-7078
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Fax | 678-669-2619
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Provider Business Mailing Address
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Address Line | 2505 NEWPOINT PKWY STE 100
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-6003
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Country | US
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Telephone | 678-257-7078
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Fax | 336-882-0236
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | DR. SAADIQ F EL-AMIN III
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Credential | MD, PHD
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Telephone | 217-816-3852
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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