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Individual
MAMIE HEXTALL
Active
Individual
MAMIE HEXTALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
15002
ND
207L00000X
Anesthesiology Physician
R-09974
IA
Other
Enumeration date
06/02/2014
Last updated
07/23/2018
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