Individual
TYLER CHURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
NMRTC, PORTSMOUTH, 620 JOHN PAUL JONES CIRCLE, PORTSMOUTH, VA 23708
(757) 953-2266
Mailing address
WALTER REED NATIONAL MILITARY CTR, 8901 WISCONSIN AVENUE, BETHESDA, MD 20889-0001
(301) 319-0451
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
0102204973
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/13/2016
Last updated
08/12/2022
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