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Member Name: Date of Birth: Insurance Identification Number: Member Phone Number: Ordering Provider Name & Specialty: Provider ID Number: Office Address: Office Phone Number: Office Fax Number: Rendering
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The Provider ID Number: is a fillable form in MS Word extension you can get filled-out and signed for certain reasons. Then, it is provided to the actual addressee in order to provide some details of any kinds. The completion and signing can be done in hard copy by hand or using a trusted tool like PDFfiller. Such applications help to submit any PDF or Word file without printing out. While doing that, you can customize it according to your requirements and put a valid e-signature. Once done, you send the Provider ID Number: to the recipient or several recipients by mail and even fax. PDFfiller has a feature and options that make your template printable. It has different options when printing out appearance. No matter, how you'll distribute a form after filling it out - in hard copy or by email - it will always look well-designed and clear. To not to create a new document from scratch again and again, turn the original document into a template. Later, you will have a rewritable sample.

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The provider ID number is a unique identifier assigned to a healthcare provider.
Healthcare providers, such as physicians, hospitals, and clinics, are required to file for a provider ID number.
The provider ID number can be filled out by submitting the necessary information and documentation to the appropriate regulatory agency.
The purpose of the provider ID number is to accurately identify healthcare providers and track their services.
The provider ID number must include information such as the healthcare provider's name, address, and specialty.
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