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Organization
U.S. MARINE CORPS FORCES COMMAND
Active
Organization
U.S. MARINE CORPS FORCES COMMAND
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL SCOTT MOELLER MD (GROUP SURGEON, 2D MARINE LOG GRP)
(910) 450-6672
Entity
Organization
Contact information
Practice address
CLR-27, 2D MLG, PSC BOX 20125, BLDG 308, HOLCOLM BLVD., CAMP LEJEUNE, NC 28542
(910) 450-6672
Mailing address
HEALTH SERVICES SUPPORT 1468 INGRAM ST, NORFOLK, VA 23551-2596
(757) 836-1685
Taxonomy
Speciality
Code
Description
License number
State
261QM1100X
Military/U.S. Coast Guard Outpatient Clinic/Center
Primary
MD-6125
HI
Other
Enumeration date
05/04/2007
Last updated
08/22/2020
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