| NPI | 1023400256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM M CONDON Bumed Ubo 240-401-3643 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1100X Clinic/Center, MilitaryU.S. Coast Guard Outpatient |
| Enumeration Date | 2015-02-25 |
| Last Update Date | 2017-11-24 |