MR. Randall Frederick Dierking JR., IDC
NPI #1790752111 in Groton, Connecticut
Provider Information
- NPI Number
- 1790752111
- Entity Type
- Individual
- Name
- MR. Randall Frederick Dierking JR., IDC
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Military Health Care Provider - Independent Duty Corpsman
- Credential
- IDC
- Enumeration Date
- Mar 3, 2006
- Last Updated
- May 3, 2010
Practice Location
- Address
- 1 WAHOO AVE
- Address 2
- UNDERSEA MEDICINE
- City
- Groton
- State
- Connecticut
- ZIP Code
- 06340-2324
- Phone
- (860) 449-4247
Specialties & Taxonomy Codes
| Specialty |
|---|
| Military Health Care Provider - Independent Duty Corpsman — Independent Duty Corpsman |
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