| NPI | 1629114004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM M CONDON Bumed Ubo 240-401-3643 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1100X Clinic/Center Military/U.S. Coast Guard Outpatient |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2017-11-13 |