Walson Medical Support Element

Organization Active NPI Military Outpatient Operational (Transportable) Component Clinic/Center · Ft. Dix, NJ

NPI 1154474419 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1154474419
Entity type
Organization (NPI type 2)
Primary specialty
Military Outpatient Operational (Transportable) Component Clinic/Center 261QM1102X
License
F333963-1 (NM)
Legal business name
WALSON MEDICAL SUPPORT ELEMENT
Practice address
5631 Baltimore Ave
Ft. Dix, NJ 08640-0000
Phone
(609) 562-5419
NPI assigned
Jan 19, 2007
Organization subpart
No

Authorized official

Name
Albert Martins, MD
Title
DCCS
Phone
(609) 562-5419

Corporate family (same tax ID) 9

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
United States Army (10 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Military Outpatient Operational (Transportable) Component Clinic/Center 261QM1102X F333963-1 NM Yes

Addresses

Primary practice location

5631 Baltimore Ave
Ft. Dix, NJ 08640-0000

Mailing address

1562 Marine Pkwy
Brooklyn, NY 11234-3414
Phone (347) 733-9938

Other providers in Ft. Dix, NJ

All providers in Ft. Dix, NJ · Military Outpatient Operational (Transportable) Component Clinic/Center in New Jersey

Sources for this page

Verify at the official NPI Registry.