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General NPI Number Information
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NPI Number | 1881251668
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Entity Type | Individual
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Provider Name | MICHAEL ANTHONY MEEHAN
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Gender | Male
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Dates
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Enumeration Date | 05/28/2019
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | COMPREHENSIVE PRIMARY CARE, LLC 761 WALTHER RD , SUITE 200
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046
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Country | US
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Telephone | 678-888-2273
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Fax | 678-888-2200
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Provider Business Mailing Address
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Address Line | COMPREHENSIVE PRIMARY CARE, LLC 3905 JOHNS CREEK CT, SUITE 200
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City | SUWANEE
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State | GA
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Zip | 30024
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Country | US
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Telephone | 678-888-2273
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Fax | 678-888-2200
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 101279
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License Number State | GA
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