Individual
ROBERT STATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
SURFACE WARFARE MEDICAL INSTITUTE, 34101 FARENHOLT AVENUE, BUILDING 14, SAN DIEGO, CA 92134-0001
(256) 684-1661
Mailing address
12 RHODE ISLAND LN, GROTON, CT 06340-6134
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
05/27/2015
Last updated
05/27/2015
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