NPI 1003357559

Steven Lee Undheim, IDC

Practitioner Independent Duty Corpsman Jacksonville, FL

Practice location

Address: 2080 Child St, Jacksonville, FL 32214-5005
Phone: (904) 546-7094

Registered specialties

Independent Duty Corpsman Primary

Other Service Providers Taxonomy 1710I1002X

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Registry record

NPI: 1003357559
Entity type: Individual
Sex (as registered): Male
NPI issued: 16 Mar 2017
Record last updated: 16 Mar 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.