Organization
UNITED STATES COAST GUARD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA LEIGH SIVER (HEALTH SERVICES TECHNICIAN)
(757) 483-8596
Entity
Organization
Contact information
Practice address
4000 COAST GUARD BLVD, PORTSMOUTH, VA 23703-2135
(757) 483-5896
Mailing address
1807 WOODGATE ARCH, CHESAPEAKE, VA 23320-7805
Taxonomy
Speciality
Code
Description
License number
State
261QM1100X
Military/U.S. Coast Guard Outpatient Clinic/Center
Primary
—
—
Other
Enumeration date
12/14/2006
Last updated
08/22/2020
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