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General NPI Number Information
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NPI Number | 1982716031
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Entity Type | Individual
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Provider Name | MICHAEL F PINGREE M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 06/24/2024
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Provider Practice Location Address
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Address Line | 3465 PIONEER PKWY STE 5
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City | WEST VALLEY CITY
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State | UT
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Zip | 84120
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Country | US
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Telephone | 801-966-0081
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Fax | 801-966-0218
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Provider Business Mailing Address
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Address Line | 3465 PIONEER PKWY STE 5
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City | WEST VALLEY CITY
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State | UT
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Zip | 84120-2081
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Country | US
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Telephone | 801-966-0081
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Fax | 801-966-0218
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 5117971-1205
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 5117971-1205
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License Number State | UT
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