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NPI 1780274456 · Independent Duty Corpsman · Patuxent River, MD
Provider details
- NPI number
- 1780274456
- Entity type
- Individual
- Primary specialty
- Independent Duty CorpsmanOther Service Providers
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Other Service Providers
Practice location
47149 Buse Rd Bldg 1370
Patuxent River, MD 20670-1540
Phone: (301) 342-1419
Approximate (ZIP-level) locationGet directions
Mailing address
47149 Buse Rd Bldg 1370
Patuxent River, MD 20670-1540
Registry dates
- Enumerated
- 2021-01-26
- Last updated
- 2024-09-16
- Certified
- 2024-09-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.