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General NPI Number Information
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NPI Number | 1942380605
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Entity Type | Organization
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Legal Business Name | GASTROINTESTINAL CLINIC OF QUAD CITIES, P.C.
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 5041 UTICA RIDGE RD SUITE 100
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City | DAVENPORT
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State | IA
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Zip | 52807-3480
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Country | US
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Telephone | 563-359-9696
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Fax | 563-359-1730
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Provider Business Mailing Address
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Address Line | 545 VALLEY VIEW DR STE 100
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City | MOLINE
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State | IL
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Zip | 61265-6138
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Country | US
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Telephone | 309-762-5560
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Fax | 309-277-1191
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Authorized Official
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Title or Position | OWENR
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Name | AMITKUMAR PATEL
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Credential | MD
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Telephone | 309-762-9711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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