IndividualActive
Elliott Pippen, IDC
NPI 1710231600 · Independent Duty Corpsman · Virginia Beach, VA
Provider details
- NPI number
- 1710231600
- Entity type
- Individual
- Primary specialty
- Independent Duty CorpsmanOther Service Providers
- Credential
- IDC
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
Other Service Providers
Practice location
1804 Gravenhurst Dr
Virginia Beach, VA 23464-8656
Phone: (757) 373-9095
Approximate (ZIP-level) locationGet directions
Mailing address
1804 Gravenhurst Dr
Virginia Beach, VA 23464-8656
Registry dates
- Enumerated
- 2012-10-31
- Last updated
- 2012-10-31
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.