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General NPI Number Information
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NPI Number | 1962536144
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Entity Type | Individual
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Provider Name | THOMAS MALLON DANIEL M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 10900 EUCLID AVENUE CWRU CENTER FOR GLOBAL HEALTH
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City | CLEVELAND
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State | OH
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Zip | 44106-7286
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Country | US
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Telephone | 216-368-6323
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Fax | 216-368-4825
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Provider Business Mailing Address
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Address Line | 43 LAUREL LAKE DR
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City | HUDSON
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State | OH
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Zip | 44236-2159
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Country | US
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Telephone | 330-655-4065
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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 | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 35.022428
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License Number State | OH
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