Organization
USN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSANO MICHEL SILVA IDC (SUBMARINE)
(904) 214-6030
Entity
Organization
Contact information
Practice address
159 CHARTER OAK DR, GROTON, CT 06340-2908
(904) 214-6030
Mailing address
159 CHARTER OAK DR, GROTON, CT 06340-2908
(904) 214-6030
Taxonomy
Speciality
Code
Description
License number
State
286500000X
Military Hospital
Primary
—
—
Other
Enumeration date
06/06/2012
Last updated
06/06/2012
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