MR. MICHAEL C ETHEREDGE II IDMT
NPI 1639729106
Military Health Care Provider - Independent Duty Medical Technicians in Langley Afb, VA

Active since September 17, 2019
77 NEALY AVE, LANGLEY AFB, VA 23665(757) 764-6800 Get Directions Write a Review

NPPES record last updated: September 17, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Michael C Etheredge Ii Idmt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. MICHAEL C ETHEREDGE II IDMT (NPI 1639729106) is an individual independent duty medical technicians provider in Langley Afb, Virginia and active in the NPI registry since September 2019.

NPPES Registry Identity

NPI1639729106
Entity TypeIndividualMale
Primary Taxonomy1710I1003X
Provider Legal NameMR. MICHAEL C ETHEREDGE IICredential: IDMT
Location Address77 NEALY AVELangley Afb, VA 23665-2040
Mailing Address77 Nealy AveLangley Afb, VA 23665-2040
Sole ProprietorNo
Enumeration DateSeptember 17, 2019
NPI 1639729106 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code1710I1003X
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.
77 NEALY AVE, Langley Afb, VA 23665

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Registered Nurse
77 NEALY AVE
LANGLEY AFB, VA 23665
Anesthesiology
77 NEALY AVE
HAMPTON, VA 23665
Psychologist (Clinical)
77 NEALY AVE
LANGLEY AFB, VA 23665
Allergy & Immunology
77 NEALY AVE
HAMPTON, VA 23665
Military Health Care Provider (Independent Duty Medical Technicians)
77 NEALY AVE
LANGLEY AFB, VA 23665
Registered Nurse
77 NEALY AVE
HAMPTON, VA 23665
Internal Medicine
77 NEALY AVE
HAMPTON, VA 23665
Physical Therapist
77 NEALY AVE
HAMPTON, VA 23665

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Michael Etheredge's NPI number?

The NPI number for Michael Etheredge is 1639729106. It was assigned to this individual provider in the NPPES registry on September 17, 2019.

Where is Michael Etheredge located?

Michael Etheredge practices at 77 Nealy Ave, Langley Afb, VA 23665. The listed phone number is (757) 764-6800.

What is Michael Etheredge's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Medical Technicians, with taxonomy code 1710I1003X.

When was this NPI record last updated?

The NPPES record for Michael Etheredge was last updated on September 17, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.