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Individual
KEVIN BRUCE GEORGE
Active
Individual
KEVIN BRUCE GEORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
103761
NC
363AM0700X
Medical Physician Assistant
010847
NY
363AS0400X
Surgical Physician Assistant
MA052674
PA
Other
Enumeration date
11/18/2005
Last updated
10/26/2016
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