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General NPI Number Information
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NPI Number | 1801096540
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Entity Type | Individual
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Provider Name | MILTON R LABARR IDC
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Gender | Male
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Dates
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Enumeration Date | 07/20/2007
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | COMMANDING OFFICER USS MONTEREY CG61 ATTN MEDICAL
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City | FPO
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State | AE
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Zip | 09578-1101
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Country | US
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Telephone | 757-963-0007
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Fax |
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Provider Business Mailing Address
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Address Line | 2212 CHERBOURG RD
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City | VIRGINIA BEACH
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State | VA
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Zip | 23455-2209
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Country | US
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Telephone | 757-445-6044
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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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