| NPI | 1316140858 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM M CONDON Bumed Ebo Manager 240-401-3643 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1100X Clinic/Center, MilitaryU.S. Coast Guard Outpatient |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2018-05-25 |