NPI 1003931163

Joshua O Balter, NAVYIDC

Practitioner Independent Duty Corpsman Groton, CT

Practice location

Address: 1 Wahoo Ave Subase Nlon, Groton, CT 06340-2324
Phone: (860) 694-4123
Fax: (860) 694-2511

Registered specialties

Independent Duty Corpsman Primary

Other Service Providers Taxonomy 1710I1002X

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Registry record

NPI: 1003931163
Entity type: Individual
Sex (as registered): Male
NPI issued: 20 Mar 2007
Record last updated: 8 Jul 2007

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.