Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. MARK MAMMOTH
Active Sole ProprietorMR. MARK MAMMOTH is a Independent Duty Corpsman healthcare provider located in GROTON, Connecticut. NPI 1760668792 is currently active in the NPPES registry. Verify at CMS.
Independent Duty Corpsman · GROTON, CT
Registration Details
- NPI Number
- 1760668792
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 22, 2008 (18.380539625252 yrs)
- Last Updated
- Jan 22, 2008
- Sole Proprietor
- Yes
Practice Information
- Address
-
1 WAHOO DRIVENAVAL BRANCH HEALTH CLINICGROTON, CT, 063495600Browse CT providers · Browse ZIP 06349
- Phone
- 8606942377
- Fax
- 8606942590
- Primary Specialty
-
Independent Duty Corpsman
1710I1002X
Other Independent Duty Corpsman Providers in GROTON, CT
| Name | Credential | NPI |
|---|---|---|
| ROY L UNDERWOOD | SFIDC | 1588631014 |
| MR. RANDALL FREDERICK DIERKING JR. | IDC | 1790752111 |
| MR. DAVID ANDREW PETERSON JR. | — | 1639147606 |
| JOHN REED | — | 1568439594 |
| MICHAEL NAPOLITANO | — | 1356318331 |
| JEFFREY LYNN MCGREGOR | IDC | 1912941980 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.