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General NPI Number Information
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NPI Number | 1851437636
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Entity Type | Individual
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Provider Name | MICHAEL O. GROWNEY MD, FACOG
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Gender | Male
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 07/13/2009
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Provider Practice Location Address
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Address Line | 1600 N GRAND AVE SUITE 400
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City | PUEBLO
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State | CO
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Zip | 81003-2700
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Country | US
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Telephone | 719-543-4000
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Fax | 719-543-1041
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Provider Business Mailing Address
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Address Line | 1600 N GRAND AVE SUITE 400
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City | PUEBLO
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State | CO
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Zip | 81003-2700
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Country | US
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Telephone | 719-543-4000
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Fax | 719-543-1041
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 2004001636
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | DR 47003
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License Number State | CO
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