| Organization Name: | 436TH MEDICAL GRP |
| NPI Number: | 1437112646 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | THERESA M. MITCHELL (AIR FORCE UBO ANALYST) |
| Mailing Address: | 300 Tuskegee Blvd Dover Afb |
| State: | DE US |
| Postal Code: | 199025003 |
| Phone Number: | 3026772649 |
| Fax Number: | 3026772051 |
| NPI Enumeration Date: | 04/10/2006 |
| NPI Last Update Date: | 05/20/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM1101X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | DE |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Military and U.S. Coast Guard Ambulatory Procedure |
| Taxonomy Definition: | That part of a |