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General NPI Number Information
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NPI Number | 1932113891
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Entity Type | Individual
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Provider Name | SAFWAT MAHER ABSOOD M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 06/22/2012
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Provider Practice Location Address
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Address Line | 500 COFFEE RD SUITE B
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City | MODESTO
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State | CA
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Zip | 95355-4926
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Country | US
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Telephone | 209-576-1621
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Fax | 209-576-2208
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Provider Business Mailing Address
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Address Line | PO BOX 4848
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City | MODESTO
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State | CA
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Zip | 95352-4848
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Country | US
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Telephone | 209-576-1621
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Fax | 209-576-2208
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | A30093
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License Number State | CA
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