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Physicians Surgery Vascular Surgery

Provider NPI: 1376559203

Provider Information:
Gender: M
Not Sole Proprietor

Practice Location:
Tel: 808-871-8346  Fax: 808-871-8344

Business Mailing Address:
PO BOX 923  WAILUKU, HI 96793-0923 US
Tel: 808-268-5789  Fax: --

NPI Information:
NPI: 1376559203
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Vascular Surgery
Thoracic Surgery (Cardiothoracic Vascular Surgery)

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 2086S0129X





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