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General NPI Number Information
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NPI Number | 1972657633
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Entity Type | Individual
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Provider Name | DANIEL RAWN EMIG M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 07/16/2013
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Provider Practice Location Address
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Address Line | 3662 N WINIFRED WAY
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86404-5959
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Country | US
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Telephone | 219-682-8738
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Fax | 928-466-9314
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Provider Business Mailing Address
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Address Line | 3662 N WINIFRED WAY
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86404-5959
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Country | US
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Telephone | 219-682-8738
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Fax | 928-466-9314
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 01063013A
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License Number State | IN
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