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Individual

MR. MICHAEL BRIAN SEXTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
IDC MILITARY

Contact information

Practice address
FPO AP 96662-2418, USS COLUMBUS SSN 762, PEARL HARBOR, HI 96860
(360) 720-1096
Mailing address
20 ELLIS ST, FREEHOLD, NJ 07728-1810
(360) 720-1096

Taxonomy

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

Other

Enumeration date
07/12/2006
Last updated
07/08/2007
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