# WALSON MEDICAL SUPPORT ELEMENT

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154474419
- **Authorized official:** ALBERT MARTINS MD (DCCS)
- **Authorized official phone:** (609) 562-5419

## Contact information

- **Practice address:** 5631 BALTIMORE AVE, FT. DIX, NJ 08640-0000
- **Practice address phone:** (609) 562-5419
- **Mailing address:** 1562 MARINE PKWY, BROOKLYN, NY 11234-3414
- **Mailing address phone:** (347) 733-9938

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1102X | Military Outpatient Operational (Transportable) Component Clinic/Center | F333963-1 | NM | Yes |

## Other

- **Enumeration date:** 01/19/2007
- **Last updated:** 08/22/2020