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General NPI Number Information
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NPI Number | 1841518495
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Entity Type | Organization
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Legal Business Name | MID ATLANTIC UROLOGY ASSOCIATES, LLC
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Dates
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Enumeration Date | 05/06/2010
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Last Update Date | 05/06/2010
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Provider Practice Location Address
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Address Line | 7809 BELLE POINT DR
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City | GREENBELT
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State | MD
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Zip | 20770-3338
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Country | US
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Telephone | 301-441-3260
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Fax | 301-474-2389
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Provider Business Mailing Address
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Address Line | 7755 BELLE POINT DR
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City | GREENBELT
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State | MD
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Zip | 20770-3316
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Country | US
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Telephone | 301-441-3260
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Fax | 301-474-2389
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. ERIC R EMANUEL
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Credential | MD
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Telephone | 301-441-3260
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number |
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License Number State |
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