Individual
ADAM T STOVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5TH BATTALION 11TH MARINES, CAMP PENDLETON, CA 92055
(760) 725-1054
Mailing address
PO BOX 555534, CAMP PENDLETON, CA 92055-5534
(760) 725-1054
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
E3456826
—
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
10/18/2017
Last updated
11/05/2024
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