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Organization

US COAST GUARD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL DAVID GREEN (TECH)
(251) 441-6404
Entity
Organization

Contact information

Practice address
2100 2ND ST SW, SUITE 5314, WASHINGTON, DC 20593-0002
(251) 441-6404
Mailing address
2100 2ND ST SW, SUITE 5314, WASHINGTON, DC 20593-0002

Taxonomy

Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary

Other

Enumeration date
01/23/2006
Last updated
08/22/2020
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