Rowdy Pameticky, IDC
Military Health Care Provider, Independent Duty Corpsman in Diamondhead, MS. Individual provider (NPI-1).
NPI number1043747553
StatusActive
Last updated in NPPESMay 15, 2017
Details
- NPI
- 1043747553
- Entity type
- Individual (NPI-1)
- Name
- Rowdy Pameticky
- Credential
- IDC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 15, 2017
- Last updated
- May 15, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1710I1002X | Military Health Care Provider, Independent Duty Corpsman | – | – | Yes |
Practice location
952 Poni PlDiamondhead, MS 39525-4135
Phone 228-813-4000
Mailing address
2603 Lower Gainsville RdStennis Ctr, MS 39529-0001
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