| NPI | 1003006628 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM MICHAEL CONDON Navy Medicine Ubo Program Manager 240-401-3643 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1100X Clinic/Center Military/U.S. Coast Guard Outpatient |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2019-04-04 |