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General NPI Number Information
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NPI Number | 1952899379
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Entity Type | Individual
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Provider Name | MICHAEL ALEXANDER BILAK MD
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Gender | Male
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Dates
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Enumeration Date | 05/01/2018
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Last Update Date | 09/01/2023
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Provider Practice Location Address
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Address Line | 1605 CHANTILLY DR NE
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City | ATLANTA
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State | GA
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Zip | 30324-3267
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Country | US
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Telephone | 404-785-7878
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Fax |
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Provider Business Mailing Address
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Address Line | 1575 NORTHEAST EXPY NE
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City | BROOKHAVEN
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State | GA
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Zip | 30329-2317
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Country | US
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Telephone | 404-785-7878
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 89734
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 89734
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License Number State | GA
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