Individual provider · Type 1 NPI
Andrew James Van Sumeren, SOTM, WP-C, NRP
Military Health Care Provider · Stennis Space Center, MS
NPI number
1043006703
Active
Practice location
2603 Lower Gainsville Road
Stennis Space Center, MS 39529-0001
Mailing address
353 State St
Bay St. Louis, MS 39520-4433
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Military Health Care Provider Primary | 171000000X | None listed |
Military Health Care Provider: Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
About NPI 1043006703
Andrew James Van Sumeren, SOTM, WP-C, NRP's National Provider Identifier is 1043006703, issued on Apr 17, 2025. The primary taxonomy on file is Military Health Care Provider (171000000X), and the practice location is in Stennis Space Center, MS. The record was last updated on Apr 17, 2025.