Us Army
Physician Assistant in Tongduchon, KYUNGKIDO. Organization (NPI-2).
NPI number1114123726
StatusActive
Last updated in NPPESAug 26, 2008
Details
- NPI
- 1114123726
- Entity type
- Organization (NPI-2)
- Legal business name
- Us Army
- Organization subpart
- No
- Enumeration date
- Jun 22, 2007
- Last updated
- Aug 26, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | – | – | Yes |
Practice location
Hhs 6-37fa, 2id, Unit#15410 Apo Ap 96224Tongduchon, KYUNGKIDO APO AP 96224
Korea, Republic of
Phone 05057302609
Mailing address
Hhs 6-37 Fa, 2id, Unit#15410 Apo Ap 15410Tongduchon, KYUNGKIDO APO AP 15410
Korea, Republic of
Phone 05057302609
Authorized official
Soo H Baek
Physician Assistant
05057302609
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