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General NPI Number Information
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NPI Number | 1861427288
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Entity Type | Individual
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Provider Name | IKRAM UL HAQ MD
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Gender | Male
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 03/18/2015
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Provider Practice Location Address
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Address Line | 750 HARRISON AVE
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City | PANAMA CITY
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State | FL
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Zip | 32401-2524
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Country | US
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Telephone | 850-913-9294
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Fax | 850-481-1820
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Provider Business Mailing Address
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Address Line | PO BOX 1442
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City | LYNN HAVEN
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State | FL
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Zip | 32444-6242
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Country | US
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Telephone | 850-913-9294
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Fax | 850-481-1820
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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 | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | ME0075189
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License Number State | FL
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