Individual provider · NPI-1

Sergeous Evgeney Anikin-Dick

Military Health Care Provider, Independent Duty Corpsman · Camp Lejeune, NC

NPI number1760967509
StatusActive
Last updated in NPPESSep 27, 2018

Details

NPI
1760967509
Entity type
Individual (NPI-1)
Name
Sergeous Evgeney Anikin-Dick
Sex
Male
Sole proprietor
No
Enumeration date
Sep 27, 2018
Last updated
Sep 27, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1710I1002X Military Health Care Provider, Independent Duty Corpsman––Yes

Practice location

2d Marine Raider Battalion Psc 20183
Camp Lejeune, NC 28542

Phone 910-440-7714

Mailing address

181 Peytons Ridge Dr
Hubert, NC 28539-3983

Phone 570-439-6591

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