1447358510 NPI number — STEVEN ROBERT WILLIAMS M.D.

Table of content: STEVEN ROBERT WILLIAMS M.D. (NPI 1447358510)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447358510 NPI number — STEVEN ROBERT WILLIAMS M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WILLIAMS
Provider First Name:
STEVEN
Provider Middle Name:
ROBERT
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447358510
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1380 LUSITANA ST STE 511
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HONOLULU
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96813-2441
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-537-3433
Provider Business Mailing Address Fax Number:
808-531-8884

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1380 LUSITANA ST
Provider Second Line Business Practice Location Address:
STE 511
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96813-2441
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-537-3433
Provider Business Practice Location Address Fax Number:
808-531-8884
Provider Enumeration Date:
09/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 02734503 , issued by the state of ( HI ) . This identifiers is of the category "MEDICAID".




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