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General NPI Number Information
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NPI Number | 1851355796
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Entity Type | Individual
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Provider Name | SAMUEL MICHAEL WILLINGER MD
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Gender | Male
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Dates
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Enumeration Date | 04/17/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3300 RIVERMONT AVE NEONATOLOGY OFFICE
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City | LYNCHBURG
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State | VA
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Zip | 24503-2030
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Country | US
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Telephone | 434-947-5611
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Fax | 434-947-3932
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Provider Business Mailing Address
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Address Line | 1909 ROYAL OAK DR
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City | LYNCHBURG
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State | VA
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Zip | 24503-1856
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Country | US
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Telephone | 434-384-5076
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Fax | 434-384-0580
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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 | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 0101043921
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License Number State | VA
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