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Ethan Cole, IDC — NPI 1871211748, Aguana, GU | NPI Central

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NPI 1871211748

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Ethan Cole, IDC

NPI 1871211748 · Independent Duty Corpsman · Aguana, GU

Provider details

NPI number: 1871211748
Entity type: Individual
Primary specialty: Independent Duty CorpsmanOther Service Providers
Credential: IDC
Sex: Male
Sole proprietor: No

Specialties & taxonomies

Independent Duty CorpsmanPrimary1710I1002X
Other Service Providers
Student in an Organized Health Care Education/Training Program390200000X
Student, Health Care

Practice location

Uss Frank Cable

Unit 100105

Aguana, GU 96567

Phone: (717) 601-4053

More GU providers

Mailing address

Uss Frank Cable

Aguana, GU 96567

Additional practice locations (1)

34101 Farenholt Ave Bldg 14
San Diego, CA 92134-7000
Phone: (717) 601-4053

Registry dates

Enumerated: 2022-08-17
Last updated: 2023-01-05
Certified: 2023-01-03

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