Doctor Name: | DR. BRET M SEBASTIAN |
NPI Number: | 1912135922 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DO |
License Number: | OS015459 |
Business Practice Address: | 100 Brewster Blvd Unit 1214 Camp Lejeune, NC - 285472538 |
Business Phone Number: | 7578039990 |
Business Fax Number: | |
Mailing Address: | 100 Brewster Blvd, CAMP LEJEUNE |
State: | NC |
Postal Code: | 285472538 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 06/29/2009 |
NPI Last Update Date: | 03/26/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | OS015459 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | PA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |