Individual
EARL GASTADOR BERCIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC, USN
Contact information
Practice address
1801 FULLER RD, MERIDIAN, MS 39309-5107
(601) 679-2633
Mailing address
1801 FULLER ROAD, MERIDIAN, MS 39305-5104
(601) 679-2633
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
12/28/2006
Last updated
07/08/2007
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