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General NPI Number Information
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NPI Number | 1972555357
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Entity Type | Organization
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Legal Business Name | UNITY HEALTHCARE, LLC
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 10/24/2007
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Provider Practice Location Address
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Address Line | 1250 S CREASY LN
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City | LAFAYETTE
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State | IN
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Zip | 47905-4960
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Country | US
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Telephone | 765-446-5417
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Fax | 765-446-5317
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Provider Business Mailing Address
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Address Line | PO BOX 4699
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City | LAFAYETTE
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State | IN
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Zip | 47903-4699
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Country | US
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Telephone | 765-446-5417
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Fax | 765-446-5317
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Authorized Official
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Title or Position | DIRECTOR OF BILLING
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Name | MARTHA K MILLER
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Credential |
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Telephone | 765-446-5286
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 207LP2900X
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 207L00000X
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License Number State | IN
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