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David S. Scharff, M.D.
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Demographics
Demographics
Last Name
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First Name
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Middle Initial
Suffix
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JR
SR
II
III
Date Of Birth
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Address
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Address 2
City
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State
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ZipCode
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Home Phone
Mobile Phone
Workphone
Email
Preferred Method of Contact
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Home Phone
Cell Phone
Work Phone
Email
Emergency contact name
Emergency contact phone number
Insurance Company
Ins. Policy Number
Ins Group Number
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