Provider Demographics
NPI:1073567475
Name:RUHLAND, GREG W (MD)
Entity Type:Individual
Prefix:DR
First Name:GREG
Middle Name:W
Last Name:RUHLAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:80 PAUAHI ST
Mailing Address - Street 2:SUITE #104
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-3065
Mailing Address - Country:US
Mailing Address - Phone:808-933-3400
Mailing Address - Fax:808-933-3401
Practice Address - Street 1:80 PAUAHI ST
Practice Address - Street 2:SUITE #104
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-3065
Practice Address - Country:US
Practice Address - Phone:808-933-3400
Practice Address - Fax:808-933-3401
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-5214208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI01918304Medicaid
HIC02112-5OtherH.M.S.A.
HI01918304Medicaid
HI55274Medicare ID - Type Unspecified