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General NPI Number Information
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NPI Number | 1861485633
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Entity Type | Individual
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Provider Name | CAROL A CALLAHAN DPM
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Gender | Female
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Dates
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Enumeration Date | 08/26/2005
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Last Update Date | 03/04/2014
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Provider Practice Location Address
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Address Line | 1817 BLACK ROCK TPKE STE 8
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City | FAIRFIELD
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State | CT
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Zip | 06825-3546
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Country | US
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Telephone | 203-330-8080
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Fax | 203-334-6924
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Provider Business Mailing Address
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Address Line | 1817 BLACK ROCK TPKE STE 8
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City | FAIRFIELD
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State | CT
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Zip | 06825-3546
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Country | US
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Telephone | 203-330-8080
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Fax | 203-334-6924
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | P00357
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License Number State | CT
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