NPI 1164818316

Deanna Mason, IDC

Practitioner Independent Duty Corpsman Hamtramck, MI

Practice location

Address: 12075 Saint Aubin St, Hamtramck, MI 48212-2626
Phone: (313) 405-4204

Registered specialties

Independent Duty Corpsman Primary

Other Service Providers Taxonomy 1710I1002X

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Registry record

NPI: 1164818316
Entity type: Individual
Sex (as registered): Female
NPI issued: 14 Apr 2015
Record last updated: 14 Apr 2015

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.