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General NPI Number Information
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NPI Number | 1932156056
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Entity Type | Individual
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Provider Name | MASOUD S HEJAZI MD
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Gender | Male
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Dates
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Enumeration Date | 05/27/2006
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Last Update Date | 09/11/2012
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Provider Practice Location Address
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Address Line | 705 PINEY FOREST RD
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City | DANVILLE
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State | VA
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Zip | 24540-2860
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Country | US
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Telephone | 434-710-4210
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Fax | 434-792-1471
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Provider Business Mailing Address
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Address Line | 705 PINEY FOREST RD
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City | DANVILLE
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State | VA
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Zip | 24540-2860
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Country | US
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Telephone | 434-710-4210
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Fax | 434-792-1471
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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 | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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License Number | 0101053286
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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License Number | 33063
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License Number State | NC
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