NPI 1023739315
Brandon Timothy Bazeluk
Practice location
- Address
- 210 Kyle Dr, Havelock, NC 28532-1773
- Phone
- (630) 297-6750
- Mailing address
- 34101 Farenholt Ave, San Diego, CA 92134-7000
Registered specialties
Independent Duty Corpsman
Primary
Registry record
- NPI
- 1023739315
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 6 Sep 2022
- Record last updated
- 10 Mar 2023
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.