NPI Registry
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Organization

U.S. NAVY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
EDWARD THEODORE MILLER IDC (INDEPENDENT DUTY CORPSMAN)
(860) 634-2876
Entity
Organization

Contact information

Practice address
BOX 159 NAVSUBASENLON, NAVAL UNDERSEA MEDICAL INSTITUTE, GROTON, CT 06340-5159
(860) 694-2876
(860) 694-3696
Mailing address
PO BOX 159, BOX 159 NAVSUBASENLON, GROTON, CT 06340-5159
(860) 694-2876
(860) 694-3696

Taxonomy

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

Other

Enumeration date
08/10/2006
Last updated
08/22/2020
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