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NPI 1013787357

IndividualActive

Bradley Gannon, IDC

NPI 1013787357 · Independent Duty Corpsman · Camp Lejeune, NC

Provider details

NPI number: 1013787357
Entity type: Individual
Primary specialty: Independent Duty CorpsmanOther Service Providers
Credential: IDC
Sex: Male
Sole proprietor: No

Practice location

2d Recon Bn 2d Marine Division

Camp Lejeune, NC 28546

Phone: (910) 440-7703

More NC providers

Mailing address

A-71 2d Recon Bn 2d Marine Division

Camp Lejeune, NC 28546

Registry dates

Enumerated: 2024-01-08
Last updated: 2024-01-08

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Bradley Gannon, IDC — NPI 1013787357, Camp Lejeune, NC | NPI Central