MR. Clifford Loren Moudy II, I.D.C.
NPI #1679541676 in Great Lakes, Illinois
Provider Information
- NPI Number
- 1679541676
- Entity Type
- Individual
- Name
- MR. Clifford Loren Moudy II, I.D.C.
- Gender
- Not Specified
- Sole Proprietor
- Not Answered
- Primary Specialty
- Military Health Care Provider - Independent Duty Corpsman
- Credential
- I.D.C.
- Enumeration Date
- Mar 8, 2006
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 3001A SIXTH ST
- Address 2
- NAVAL HOSPITAL GREAT LAKES
- City
- Great Lakes
- State
- Illinois
- ZIP Code
- 60088-5230
- Phone
- (847) 688-2616
Specialties & Taxonomy Codes
| Specialty |
|---|
| Military Health Care Provider - Independent Duty Corpsman — Independent Duty Corpsman |
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