Provider Demographics
NPI:1144311879
Name:MEURS, WANDA G (MD)
Entity type:Individual
Prefix:DR
First Name:WANDA
Middle Name:G
Last Name:MEURS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:120 PAUAHI STREET
Mailing Address - Street 2:SUITE #305
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720
Mailing Address - Country:US
Mailing Address - Phone:808-969-3222
Mailing Address - Fax:808-961-0046
Practice Address - Street 1:120 PAUAHI STREET
Practice Address - Street 2:SUITE #305
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720
Practice Address - Country:US
Practice Address - Phone:808-969-3222
Practice Address - Fax:808-961-0046
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD5351208000000X, 2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics
Not Answered2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIB21366OtherHMSA
HI019425-01Medicaid
HI0000BFCMSMedicare ID - Type Unspecified
HI019425-01Medicaid