Provider Demographics
NPI:1073739710
Name:JAMES M WARNER MD LLC
Entity Type:Organization
Organization Name:JAMES M WARNER MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:WARNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-678-7370
Mailing Address - Street 1:91-2141 FORT WEAVER RD
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-1993
Mailing Address - Country:US
Mailing Address - Phone:808-678-7370
Mailing Address - Fax:808-678-7240
Practice Address - Street 1:91-2141 FORT WEAVER RD
Practice Address - Street 2:
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-1993
Practice Address - Country:US
Practice Address - Phone:808-678-7370
Practice Address - Fax:808-678-7240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD11902207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH100740Medicare ID - Type Unspecified
HII40669Medicare UPIN