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General NPI Number Information
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NPI Number | 1942647185
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Entity Type | Individual
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Provider Name | JASON F HINE M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/29/2013
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Last Update Date | 08/14/2016
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Provider Practice Location Address
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Address Line | E1 CLAIRMONT CT
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City | PORTLAND
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State | ME
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Zip | 04103-4459
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Country | US
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Telephone | 203-641-4085
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Fax |
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Provider Business Mailing Address
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Address Line | E1 CLAIRMONT CT
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City | PORTLAND
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State | ME
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Zip | 04103-4459
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Country | US
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Telephone | 203-641-4085
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Fax |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MT204482
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MD20978
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License Number State | ME
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