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Contact Information

RANDY S BREIDEL, SUB IDC
DAM NECK ANNEX
1885 TERRIER AVE STE 100
VIRGINIA BEACH, VA23461-2298
 Phone: 757-314-7221
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Independent Duty Corpsman

1710I1002X
Indicates primary specialty

NPI Profile & details for RANDY S BREIDEL · (Male)

NPI Number 1265401673
Status Active
Credentials SUB IDC
Entity Individual
Enumeration date 03/16/2006
Last updated 07/21/2022 - About 4 years ago
Sole proprietor 1 Yes
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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