Micheal A Benamon

Individual provider Active NPI Independent Duty Medical Technicians · Fort Rucker, AL

NPI 1972749554 · NPPES record last updated Jan 2, 2009

Key facts

NPI
1972749554
Entity type
Individual (NPI type 1)
Primary specialty
Independent Duty Medical Technicians 1710I1003X
Practice address
301 Andrews Avenue
Lyster Army Health Clinic
Fort Rucker, AL 36362-5333
Phone
(334) 255-7169
Fax
(334) 255-7173
NPI assigned
Jan 2, 2009
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 Medical Technicians 1710I1003X Yes

Addresses

Primary practice location

301 Andrews Avenue
Lyster Army Health Clinic
Fort Rucker, AL 36362-5333

Mailing address

301 Andrews Avenue
Lyster Army Health Clinic
Fort Rucker, AL 36362-5333
Phone (334) 255-7169

Other providers in Fort Rucker, AL

All providers in Fort Rucker, AL · Independent Duty Medical Technicians in Alabama

Sources for this page

Verify at the official NPI Registry.