Individual
MICHAEL CHAD GANDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
ANTI-TERRORISM BATTALION, 2ND MARINE DIVISION, UNIT 20165, CAMP LEJEUNE, NC 28542-0165
(910) 450-9431
(910) 450-9223
Mailing address
234 BROOKSTONE WAY, JACKSONVILLE, NC 28546-9539
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
05/17/2007
Last updated
07/08/2007
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