Provider Demographics
NPI:1083769756
Name:OAHU GASTROENTEROLOGY INC
Entity Type:Organization
Organization Name:OAHU GASTROENTEROLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROLAND
Authorized Official - Middle Name:BOON CHUAN
Authorized Official - Last Name:TER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-548-6008
Mailing Address - Street 1:111 HEKILI ST
Mailing Address - Street 2:SUITE A, #398
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-2800
Mailing Address - Country:US
Mailing Address - Phone:808-741-4292
Mailing Address - Fax:808-548-6006
Practice Address - Street 1:405 N KUAKINI ST
Practice Address - Street 2:SUITE 1108
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-6300
Practice Address - Country:US
Practice Address - Phone:808-548-6008
Practice Address - Fax:808-548-6006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD12308207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty