Provider Demographics
NPI:1003884057
Name:MINCHIN, DAVID (SFIDC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:MINCHIN
Suffix:
Gender:M
Credentials:SFIDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 819, BOX 18- 50
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AE
Mailing Address - Zip Code:09645
Mailing Address - Country:US
Mailing Address - Phone:3495-682-3307
Mailing Address - Fax:
Practice Address - Street 1:PSC 819, BOX 18- 50
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AE
Practice Address - Zip Code:09645
Practice Address - Country:US
Practice Address - Phone:3495-682-3307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2008-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman