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General NPI Number Information
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NPI Number | 1972692002
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Entity Type | Individual
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Provider Name | MELANIE JAN BAMERT MD
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Gender | Female
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 169 ASHLEY AVE
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City | CHARLESTON
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State | SC
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Zip | 29403-5836
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Country | US
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Telephone | 843-792-2100
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Fax |
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Provider Business Mailing Address
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Address Line | 1144 CLEARSPRING DR
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City | CHARLESTON
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State | SC
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Zip | 29412-9670
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Country | US
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Telephone | 843-364-0493
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | LL27205
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License Number State | SC
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