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General NPI Number Information
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NPI Number | 1992769954
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Entity Type | Individual
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Provider Name | LANCE ADAM COHEN M.D
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Gender | Male
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Dates
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Enumeration Date | 04/14/2006
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Last Update Date | 10/12/2009
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Provider Practice Location Address
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Address Line | 20701 N SCOTTSDALE RD #107-499
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-6413
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Country | US
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Telephone | 602-980-1009
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Fax | 480-563-4709
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Provider Business Mailing Address
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Address Line | 22025 N 79TH PL
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-4893
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Country | US
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Telephone | 480-563-4706
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Fax | 480-563-4709
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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 | 24583
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License Number State | AZ
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