Organization
COMDT(CG-1122) U.S. CAOST GUARD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. YUSUF D'COBLA WILLIAMS (HEALTH SERVICES TECHNICIAN)
(757) 856-2230
Entity
Organization
Contact information
Practice address
2100 2ND ST SW, SUITE 5314, WASHINGTON, DC 20593-0002
(757) 856-2230
(757) 856-2276
Mailing address
2100 2ND ST SW, SUITE 5314, WASHINGTON, DC 20593-0002
(757) 856-2230
(757) 856-2276
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
24720000X
DC
Other
Enumeration date
10/04/2006
Last updated
08/22/2020
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