Individual provider · Type 1 NPI

Michael Glen Peck Jr., IDC

Independent Duty Corpsman · Pearl Harbor, HI

NPI number 1407898539 Active

Practice location

822 Clark St, Suite 400
Pearl Harbor, HI 96860-4652

Call (808) 473-1094 Map

Fax (808) 473-3109

Mailing address

86-227 Moelua St
Waianae, HI 96792-4417

Specialties and licenses

TaxonomyCodeLicense
Independent Duty Corpsman Primary 1710I1002XNone listed

Independent Duty Corpsman: A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and othe…

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About NPI 1407898539

Michael Glen Peck Jr., IDC's National Provider Identifier is 1407898539, issued on Jun 12, 2006. The primary taxonomy on file is Independent Duty Corpsman (1710I1002X), and the practice location is in Pearl Harbor, HI. The record was last updated on Jul 13, 2026.