Samuel Wade Cuidon, IDMT
Individual provider Active NPI Independent Duty Medical Technicians · Eielson Afb, AK
NPI 1316535487 · NPPES record last updated Jul 12, 2022
Key facts
- NPI
- 1316535487
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Independent Duty Medical Technicians 1710I1003X
- Practice address
- 2630 Central Ave # 3349
Eielson Afb, AK 99702-2301 - Phone
- (405) 582-6048
- NPI assigned
- Jan 5, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 Medical Technicians | 1710I1003X | Yes |
Addresses
Primary practice location
2630 Central Ave # 3349
Eielson Afb, AK 99702-2301
Mailing address
2630 Central Ave # 3349
Eielson Afb, AK 99702-2301
Other providers in Eielson Afb, AK
- Angelia Deanne Calder
- Gretchen Kay Casci
- Jessica Castro
- Jolanda Jeanette Cook
- Matthew Gray Corbin
- Melanie Marie Cusi
- Jamie Yvonne Custodio
- Tara Marie Dillow
- Alton E Doe Jr.
- Brad T Driscoll
All providers in Eielson Afb, AK · Independent Duty Medical Technicians in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 12, 2022. 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.