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General NPI Number Information
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NPI Number | 1841215647
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Entity Type | Individual
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Provider Name | MARK VRANICAR MD
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Gender | Male
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 1446 HARPER ST FL 6
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City | AUGUSTA
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State | GA
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Zip | 30912-0001
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Country | US
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Telephone | 706-721-8522
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Fax |
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Provider Business Mailing Address
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Address Line | 1120 15TH ST # BA8305
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City | AUGUSTA
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State | GA
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Zip | 30912-0004
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Country | US
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Telephone | 706-721-2336
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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 | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number | 36423
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number | 89693
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License Number State | GA
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