Provider Demographics
NPI:1225263320
Name:WEBB, EDDIE C (IDMT)
Entity Type:Individual
Prefix:MR
First Name:EDDIE
Middle Name:C
Last Name:WEBB
Suffix:
Gender:M
Credentials:IDMT
Other - Prefix:
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Mailing Address - Street 1:162 DODD BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:LANGLEY AFB
Mailing Address - State:VA
Mailing Address - Zip Code:23665-1916
Mailing Address - Country:US
Mailing Address - Phone:757-764-5986
Mailing Address - Fax:757-764-4631
Practice Address - Street 1:162 DODD BLVD
Practice Address - Street 2:STE 100
Practice Address - City:LANGLEY AFB
Practice Address - State:VA
Practice Address - Zip Code:23665-1916
Practice Address - Country:US
Practice Address - Phone:757-764-5986
Practice Address - Fax:757-764-4631
Is Sole Proprietor?:No
Enumeration Date:2009-05-19
Last Update Date:2009-05-19
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians