Individual
MR. DANIEL WILLIAM FEEBACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
667 JOHN PAUL JONES CIR NAVAL MEDICAL CENTER PORTSMOUTH, MEDICAL DEPARTMENT(CODE NO2M), NORFOLK, VA 23511-2419
(757) 443-0026
(757) 443-5706
Mailing address
4121 SHORELINE CIR APT 118, VIRGINIA BEACH, VA 23452-2165
(757) 469-9642
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1710I1002X
INDEPENDENT DUTY CORPSMAN
NC
Enumeration date
05/17/2006
Last updated
12/20/2012
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