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General NPI Number Information
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NPI Number | 1952563728
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Entity Type | Individual
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Provider Name | JACQUELENN MARIE STUHLDREHER MD
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Gender | Female
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Dates
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Enumeration Date | 07/01/2008
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Last Update Date | 10/09/2020
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Provider Practice Location Address
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Address Line | 3000 COLISEUM DR STE 100
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City | HAMPTON
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State | VA
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Zip | 23666-5963
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Country | US
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Telephone | 757-736-7250
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Fax | 757-224-2198
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Provider Business Mailing Address
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Address Line | 3000 COLISEUM DR STE 100
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City | HAMPTON
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State | VA
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Zip | 23666-5963
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Country | US
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Telephone | 757-736-7250
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Fax | 757-224-2198
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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 | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 35121246
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 35.121246
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 0101266205
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License Number State | VA
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