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General NPI Number Information
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NPI Number | 1922019793
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Entity Type | Organization
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Legal Business Name | ENID GASTROENTEROLOGY, INC., P.C.
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 01/31/2012
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Provider Practice Location Address
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Address Line | 330 S 5TH ST SUITE 301
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City | ENID
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State | OK
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Zip | 73701-5825
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Country | US
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Telephone | 580-234-0285
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Fax | 580-234-0590
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Provider Business Mailing Address
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Address Line | 330 S 5TH ST SUITE 301
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City | ENID
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State | OK
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Zip | 73701-5825
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Country | US
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Telephone | 580-234-0285
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Fax | 580-234-0590
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | DR. SANKU ROHINI
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Credential | MD
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Telephone | 582-234-0285
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 12331
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License Number State | OK
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