IndividualActive
Andrew Bickham, IDC
NPI 1396061933 · Independent Duty Corpsman · Groton, CT
Provider details
- NPI number
- 1396061933
- Entity type
- Individual
- Primary specialty
- Independent Duty CorpsmanOther Service Providers
- Credential
- IDC
- Sex
- Male
- Sole proprietor
- No
- License
- T69-52-2586 (VA)
Specialties & taxonomies
Other Service Providers
Practice location
159 Trout Avenue
Groton, CT 06340
Phone: (860) 694-2876
Approximate (ZIP-level) locationGet directions
Mailing address
9 Cormorant Rd
Groton, CT 06340-3110
Registry dates
- Enumerated
- 2010-04-07
- Last updated
- 2010-04-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.