Michael Todd Shull, IDC
Individual provider Active NPI Independent Duty Corpsman · Kings Bay, GA
NPI 1972565463 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1972565463
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Independent Duty Corpsman 1710I1002X
- Practice address
- 881 Uss James Madison Rd
Kings Bay, GA 31547-2531 - Phone
- (912) 573-2410
- NPI assigned
- Apr 3, 2006
- 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
881 Uss James Madison Rd
Kings Bay, GA 31547-2531
Mailing address
108 Honeysuckle Rd
Kingsland, GA 31548-6486
Phone (912) 576-8169
Other providers in Kings Bay, GA
- Amy Faye Priest
- Gary Robertson
- Cory Dean Sant
- Samuel Sarpong
- Brian Shea
- Mark Timothy Sizemore
- Hillary Constance Smith
- John Hugh Steely
- Kristin Sthole
- Stephanie Denise Sulewski
All providers in Kings Bay, GA · Independent Duty Corpsman in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. 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.