NPI 1871211748

Ethan Conall Cole, IDC

Practitioner Independent Duty Corpsman Aguana, GU

Practice location

Address: Uss Frank Cable Unit 100105, Aguana, GU 96567
Phone: (717) 601-4053
Mailing address: Uss Frank Cable Unit 100105 Box 216 Fpo, Ae 96567-0502, Aguana, GU 96567

Registered specialties (2)

Independent Duty Corpsman Primary

Other Service Providers Taxonomy 1710I1002X

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Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

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Registry record

NPI: 1871211748
Entity type: Individual
Sex (as registered): Male
NPI issued: 17 Aug 2022
Record last updated: 5 Jan 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.