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NPI 1285042713

NPI 1285042713 : STEVEN STILL IDC : MANAMA, MANAMA

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General NPI Number Information
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    NPI Number           |    1285042713
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    Entity Type          |    Individual 
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    Provider Name        |    STEVEN STILL IDC
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    07/29/2014
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    Last Update Date     |    07/29/2014
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Provider Practice Location Address
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    Address Line         |    USS FIREBOLT PC 10 
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    City                 |    MANAMA
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    State                |    MANAMA
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    Zip                  |    FPO AE 09569 1969
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    Country              |    BH
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    Telephone            |    318-439-9766
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    USS FIRBOLT PC 10 FPOAE 09569 1969
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    City                 |    MANAMA
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    State                |    MANAMA
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    Zip                  |    09569 1969
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    Country              |    BH
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1710I1002X
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    Taxonomy Name        |    Independent Duty Corpsman
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    License Number       |    
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    License Number State |    
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