Individual
MICHAEL NUTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
BLDG 517 TAUGTOG AVE, NAVSUBSCOL, GROTON, CT 06349
(559) 381-5698
Mailing address
PO BOX 700 N443, NAVSUBSCOL, GROTON, CT 06349
(559) 381-5698
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
07/10/2007
Last updated
02/08/2008
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