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General NPI Number Information
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NPI Number | 1982891297
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Entity Type | Individual
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Provider Name | MISAKO MCLEOD DPM
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Gender | Female
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Dates
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Enumeration Date | 10/01/2007
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Last Update Date | 08/14/2024
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Provider Practice Location Address
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Address Line | 67 WAIANUENUE AVENUE
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City | HILO
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State | HI
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Zip | 96720
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Country | US
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Telephone | 808-961-3668
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Fax |
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Provider Business Mailing Address
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Address Line | 67-1249 KOALIULA PL
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City | KAMUELA
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State | HI
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Zip | 96743-8463
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Country | US
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Telephone | 415-302-0239
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Fax | 844-412-6553
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | E4736
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 1107
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | PO-215
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License Number State | HI
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