Provider Demographics
NPI:1396712410
Name:ARTILLAGA, ARIELITO QUICHO (IDC)
Entity type:Individual
Prefix:MR
First Name:ARIELITO
Middle Name:QUICHO
Last Name:ARTILLAGA
Suffix:
Gender:M
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 476 BOX 715
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96665-1737
Mailing Address - Country:JP
Mailing Address - Phone:8195-650-8229
Mailing Address - Fax:
Practice Address - Street 1:PSC 476 BOX 715
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96665-1737
Practice Address - Country:JP
Practice Address - Phone:8195-650-8229
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman