Organization
WALSON MEDICAL SUPPORT ELEMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALBERT MARTINS MD (DCCS)
(609) 562-5419
Entity
Organization
Contact information
Practice address
5631 BALTIMORE AVE, FT. DIX, NJ 08640-0000
(609) 562-5419
Mailing address
1562 MARINE PKWY, BROOKLYN, NY 11234-3414
(347) 733-9938
Taxonomy
Speciality
Code
Description
License number
State
261QM1102X
Military Outpatient Operational (Transportable) Component Clinic/Center
Primary
F333963-1
NM
Other
Enumeration date
01/19/2007
Last updated
08/22/2020
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