MEDICARE: U.S. NAVY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	286500000X	Military Hospital

General Provider Information

NPI Number	:	1487918629
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	U.S. NAVY

Provider Business Mailing Address
First Line	:	350 CRAG RD
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32407-7013
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	350 CRAG RD
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32407-7013
Country	:	US
Telephone Number	:	850-235-5215
Fax Number	:	850-235-5993

Authorized Official
Title or Position	:	DIVING MEDICAL OFFICER NDSTC
Name	:	MR. ADAM SONGER
Credential	:	M.D.
Telephone Number	:	850-235-5247

Provider Enumeration Date	:	07/03/2012
Last Update Date	:	07/03/2012

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Directions to “U.S. NAVY ” Practice Location

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