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Individual

MR. FREDERICK JAMES CHARD IV

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
IDC

Contact information

Practice address
55 SOUTH RD APT 4B, GROTON, CT 06340-4641
(860) 356-6153
Mailing address
55 SOUTH RD APT 4B, GROTON, CT 06340-4641
(860) 356-6153

Taxonomy

Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary

Other

Enumeration date
02/26/2014
Last updated
02/26/2014
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