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NPI 1891975207

NPI 1891975207 : CHARLES DAVID MARET RPH : DALTON, GA

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General NPI Number Information
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    NPI Number           |    1891975207
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    Entity Type          |    Individual 
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    Provider Name        |    CHARLES DAVID MARET RPH
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    11/14/2007
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    Last Update Date     |    11/14/2007
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Provider Practice Location Address
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    Address Line         |    128 HUNTINGTON RD 
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    City                 |    DALTON
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    State                |    GA
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    Zip                  |    30720-3854
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    Country              |    US
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    Telephone            |    706-278-0100
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    Fax                  |    706-259-3291
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Provider Business Mailing Address
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    Address Line         |    128 HUNTINGTON RD 
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    City                 |    DALTON
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    State                |    GA
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    Zip                  |    30720-3854
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    Country              |    US
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    Telephone            |    706-278-0100
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    Fax                  |    706-259-3291
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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       |    8714
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    License Number State |    GA
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