NPI 1053560995

Thomas Carter Randolph, IDC

Practitioner Independent Duty Corpsman Fpo, AE

Practice location

Address: Uss Elrod Ffg 55, Fpo, AE 09568-1509
Phone: (757) 444-2000

Registered specialties

Independent Duty Corpsman Primary

Other Service Providers Taxonomy 1710I1002X

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Registry record

NPI: 1053560995
Entity type: Individual
Sex (as registered): Male
NPI issued: 16 Sep 2008
Record last updated: 16 Sep 2008

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.