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Organization
UNITED STATES NAVY
Active
Organization
UNITED STATES NAVY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDY SHANARD CUNNINGHAM IDC (INDEPENDENT DUTY CORPSMAN)
(205) 936-6013
Entity
Organization
Contact information
Practice address
SURFACE WARFARE MEDICAL INSTITUTE, 34101 FARENHOLT AVENUE, BUILDING 14, SAN DIEGO, CA 92134-5291
(619) 532-7968
Mailing address
SURFACE WARFARE MEDICAL INSTITUTE, 34101 FARENHOLT AVENUE, BUILDING 14, SAN DIEGO, CA 92134-5291
(619) 532-7968
Taxonomy
Speciality
Code
Description
License number
State
286500000X
Military Hospital
Primary
H01236278
HI
Other
Enumeration date
05/07/2014
Last updated
05/07/2014
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