NPI 1053138958

Henry Ian Blom

Practitioner Independent Duty Corpsman Fpo, AA

Practice location

Address: 1st Marine Raider Battalion Psc Box 20184, Fpo, AA 28542
Phone: (910) 440-2494

Registered specialties

Independent Duty Corpsman Primary

Other Service Providers Taxonomy 1710I1002X

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Registry record

NPI: 1053138958
Entity type: Individual
Sex (as registered): Male
NPI issued: 23 Sep 2024
Record last updated: 23 Sep 2024

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.