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General NPI Number Information
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NPI Number | 1962589481
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Entity Type | Organization
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Legal Business Name | ANTHONY GIORDANO DPM PC
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 12/10/2007
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Provider Practice Location Address
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Address Line | 51523 VAN DYKE AVE
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City | SHELBY TOWNSHIP
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State | MI
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Zip | 48316-4447
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Country | US
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Telephone | 734-812-3194
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Fax |
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Provider Business Mailing Address
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Address Line | 19832 DEMIL DR
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City | MACOMB
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State | MI
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Zip | 48044-6313
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Country | US
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Telephone | 734-812-3194
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. ANTHONY GIORDANO
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Credential | DPM
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Telephone | 734-812-3194
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 5901002058
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License Number State | MI
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