Dierking, Randall Frederick
Dierking, Randall Frederick is an individual health care provider with primary practice located at 1 Wahoo Ave Undersea Medicine, Groton CT 06340-2324. He recently has only one registered license in Other Service Providers / Independent Duty Corpsman, which is considered as his primary health care specialty. Dierking, Randall Frederick can be contacted via phone (860) 449-4247.Contact Information
Primary practice address
1 Wahoo Ave Undersea Medicine
Groton CT 06340-2324
Phone: (860) 449-4247
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Independent Duty Corpsman | 1710I1002X |
Profile Details
| NPI number | 1790752111 |
|---|---|
| LBN Legal business name | Dierking, Randall Frederick |
| Credentials | IDC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 3rd, 2006 |
| Last updated | May 3rd, 2010 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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