Rowdy Pameticky, IDC
Individual provider Active NPI Independent Duty Corpsman · Diamondhead, MS
NPI 1043747553 · NPPES record last updated May 15, 2017
Key facts
- NPI
- 1043747553
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Independent Duty Corpsman 1710I1002X
- Practice address
- 952 Poni PL
Diamondhead, MS 39525-4135 - Phone
- (228) 813-4000
- NPI assigned
- May 15, 2017
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Independent Duty Corpsman | 1710I1002X | Yes |
Addresses
Primary practice location
952 Poni PL
Diamondhead, MS 39525-4135
Mailing address
2603 Lower Gainsville Rd
Stennis Ctr, MS 39529-0001
Other providers in Diamondhead, MS
- Stewart Allen Nutting
- Ochsner Mississippi, LLC
- Ochsner Mississippi, LLC
- Ochsner Mississippi, LLC
- Ochsner Mississippi, LLC
- Connie McDaniel Plavnick
- Gary S. Porter
- Post Acute Holdings LLC
- Quest Rehab Inc
- Ann Reed
All providers in Diamondhead, MS · Independent Duty Corpsman in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 15, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.