Individual
MICHAEL STEVEN ELLIOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SOIDC
Contact information
Practice address
1ST MARINE SPECIAL OPERATIONS BTN., BOX 555341, CAMP PENDLETON, CA 92055-5341
(760) 725-5298
Mailing address
1ST MARINE SPECIAL OPERATIONS BTN., CAMP PENDLETON, CA 92055, APO, AP 92055
(509) 780-1453
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
10126925ME
NC
Other
Enumeration date
04/11/2012
Last updated
04/11/2012
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