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General NPI Number Information
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NPI Number | 1871974022
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Entity Type | Individual
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Provider Name | MARK CIPRIANI JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/13/2015
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Last Update Date | 10/14/2019
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Provider Practice Location Address
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Address Line | 200 1ST ST SW
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City | ROCHESTER
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State | MN
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Zip | 55905-0001
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Country | US
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Telephone | 507-284-2511
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Fax |
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Provider Business Mailing Address
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Address Line | 1 PARK WEST BLVD STE 330
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City | AKRON
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State | OH
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Zip | 44320-4226
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Country | US
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Telephone | 330-835-5533
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Fax | 234-312-2341
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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 | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 35.137170
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License Number State | OH
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