NPI 1013885201

Maxwell Ian Tenzer

Practitioner Independent Duty Corpsman Apo, AA

Practice location

Address: 2d Mardiv 2d Reconnaissance Bn Camp Lejeune, Apo, AA 28542-0138
Phone: (914) 806-8477

Registered specialties

Independent Duty Corpsman Primary

Other Service Providers Taxonomy 1710I1002X

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Registry record

NPI: 1013885201
Entity type: Individual
Sex (as registered): Male
NPI issued: 28 Oct 2025
Record last updated: 28 Oct 2025

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.