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1396420022
DAVID MEDINA
SPRINGFIELD, IL
NPI
1396420022
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: IL 125082387)
Enumeration Date
2023-06-20
Last Update Date
2023-06-20
Business Address
DAVID MEDINA MD
520 N 4TH ST
SPRINGFIELD, IL 62702-5238
Phone number: 217-545-8000
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Mailing Address
DAVID MEDINA MD
PO BOX 19670
SPRINGFIELD, IL 62794-9670
Phone number: 217-545-8000
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