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Individual
MAX EDWARD OWEN
Active
Individual
MAX EDWARD OWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1540
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1540
PHYSICIAN ASSISTANTS
OK
Enumeration date
08/01/2006
Last updated
03/19/2013
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