Individual
MR. MICHAEL JAMES ELMER I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SOIDC
Contact information
Practice address
2D RECON BN, PSC BOX 20138, CAMP LEJEUNE, NC 28542-0138
(910) 440-7712
Mailing address
2D RECON BN, PSC BOX 20138, CAMP LEJEUNE, NC 28542-0138
(910) 440-7712
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
NC
Other
Enumeration date
10/03/2012
Last updated
10/03/2012
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