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NPI 1972646487

NPI 1972646487 : INDIRA MADAPATI M.D : MANVILLE, NJ

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General NPI Number Information
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    NPI Number           |    1972646487
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    Entity Type          |    Individual 
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    Provider Name        |    INDIRA MADAPATI M.D
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/14/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    204 S MAIN ST 
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    City                 |    MANVILLE
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    State                |    NJ
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    Zip                  |    08835-1806
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    Country              |    US
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    Telephone            |    908-722-2992
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    10 MOZART CT 
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    City                 |    EAST WINDSOR
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    State                |    NJ
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    Zip                  |    08520-5117
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    Country              |    US
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    Telephone            |    908-768-0757
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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        |    207R00000X
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    Taxonomy Name        |    Internal Medicine Physician
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    License Number       |    25MA07427400
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    License Number State |    NJ
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