Taxonomy Code 1710I1003X(1710i1003x)
Independent Duty Medical Technicians. Providers: 12

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Independent Duty Medical Technicians Providers

NPI Name Type Address

1023085883

MR. MA Anthony Petrone JR.

Individual

140 Sylvester Rd

San Diego, CA

1851368229

MR. IDC Carlos M. Coleman

Individual

34101 Farenholt Ave

Nshs-sd Idc Dept

San Diego, CA

1730157736

MR. IDC Alfredo Alcalaesparza

Individual

2211 Pacific Beach Dr

San Diego, CA

1932169380

Shirley Hovlid

Individual

2650 Stockton Rd

San Diego, CA

1467674150

MR. IDCDMT John Dudley Harris JR.

Individual

33000 Nixie Way Bldg 50

San Diego, CA

1740481571

IDC Cindy S Cruzan

Individual

34101 Farenholt Ave

San Diego, CA

1689873192

IDC Keith Robert Davis

Individual

140 Sylvester Rd

Uss Topeka (ssn 754) Fpo Ap 96679-2410

San Diego, CA

1497927404

MS. IDC Keren Mireya Lemas

Individual

2450 Craven St

San Diego, CA

1346552064

MR. DIVE IDC Jeffrey Thomas Gilbert

Individual

3841 Colina Dorado Dr

Apartment G108

San Diego, CA

1093124398

IDC Benjamin Ryan Foy

Individual

2784 Hornet Way

San Diego, CA

1023334158

MR. Billy L Fuson JR.

Individual

6656 Antigua Blvd

San Diego, CA

1447606322

IDC Jeffrey Tyler Whitson

Individual

34101 Farenholt Ave

Building 14

San Diego, CA

How to obtain, renew, or terminate an NPI

Every health care provider, whether it’s a hospital, pharmacy, or individual specialist, must obtain their own NPI number. This identification number is unique and is assigned upon application. In tod...

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Taxonomy Code 1710I1003X
Specialization Independent Duty Medical Technicians
Display Name Independent Duty Medical Technicians
Taxonomy Group Other Service Providers
Taxonomy Classification Military Health Care Provider
Definition An Independent Duty Medical Technician (IDMT) is specially trained and educated to perform primary medical care, minor surgical services, and treatment of dental disorders for active duty military members in a variety of health care and non-health care settings worldwide under direct and indirect physician supervision. An IDMT may take medical histories, perform physical exams, order lab tests and x-rays, prescribe medications, and give immunizations. IDMTs work under the direct supervision of a physician preceptor when at home station and indirectly when assigned to a Mobile Aid Station, Mobile Medical Unit, remote site, or otherwise deployed specifically as an IDMT. An IDMT may be an experienced Aerospace Medical Service Technician who meets special task qualifications and is recommended for training by the Aerospace Medical Service Functional Manager at their Medical Treatment Facility. IDMTs maintain certification as Nationally Registered Emergency Medical Technicians and as Immunization Back-up Technicians.
Effective Date September 30, 2009
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Military Health Care Provider Codes

Independent Duty Corpsman

1710I1002X • providers: 3,002

Military Health Care Provider

171000000X • providers: 1,689