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General NPI Number Information
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NPI Number | 1861037004
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Entity Type | Individual
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Provider Name | ANGELA L DAVIS
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Gender | Female
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Dates
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Enumeration Date | 11/12/2019
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Last Update Date | 11/12/2019
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Provider Practice Location Address
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Address Line | 8520 BASH ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46250
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Country | US
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Telephone | 877-548-5151
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Fax | 877-313-5252
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Provider Business Mailing Address
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Address Line | 8847 E MICHIGAN ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46219-5556
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Country | US
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Telephone | 317-701-6547
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 26018240A
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License Number State | IN
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