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Individual
MICHAEL DODGE
Active
Individual
MICHAEL DODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
PTL6422
CA
2084P0800X
Psychiatry Physician
Primary
A180895
CA
Other
Enumeration date
04/06/2021
Last updated
04/24/2024
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