Michael Glen Peck Jr., IDC

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

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

Phone

(808) 473-1094

Fax

(808) 473-3109

NPI assigned

Jun 12, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1407898539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86-227 MOELUA ST",
            "city": "WAIANAE",
            "state": "HI",
            "postal_code": "967924417",
            "telephone_number": "808-696-4373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 CLARK ST",
            "address_2": "SUITE 400",
            "city": "PEARL HARBOR",
            "state": "HI",
            "postal_code": "968604652",
            "telephone_number": "808-473-1094",
            "fax_number": "808-473-3109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "MICHAEL",
        "middle_name": "GLEN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "IDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Analisa G Page, RN
• Grant Hudson Palmer, DMD
• Lynette Parker, RN
• Melinda Ranee Parker, RN
• Jorge H Parra Betancourt, DDS
• Christopher G Pellejera, O.D.
• Dora Enid Pena-Mam, RN
• Valerie Lynn Perez, PSYD
• Johvin Perry
• Melanie Angela Perry, DDS

• Independent Duty Corpsman in Pearl Harbor, HI
• Providers in Pearl Harbor, HI by specialty
• Independent Duty Corpsman in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.