Michael Shannon Clifton, IDC

Individual provider Active NPI Independent Duty Corpsman · Fpo Ap, CA

NPI 1891970026 · NPPES record last updated Jan 7, 2008

Key facts

NPI
1891970026
Entity type
Individual (NPI type 1)
Primary specialty
Independent Duty Corpsman 1710I1002X
Practice address
NMCB 5
Unit 25294
Fpo Ap, CA 96601-4961
Phone
(757) 630-7930
NPI assigned
Jan 7, 2008
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)CodeLicenseStatePrimary
Independent Duty Corpsman 1710I1002X Yes

Addresses

Primary practice location

NMCB 5
Unit 25294
Fpo Ap, CA 96601-4961

Mailing address

NMCB 5
Unit 25294
Fpo Ap, CA 96601-4961

Other providers in Fpo Ap, CA

All providers in Fpo Ap, CA · Independent Duty Corpsman in California

Sources for this page

Verify at the official NPI Registry.