Provider Demographics
NPI:1295829653
Name:DANG, ANDREW WY (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:WY
Last Name:DANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:95-1249 MEHEULA PKWY
Mailing Address - Street 2:UNIT 187
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-1779
Mailing Address - Country:US
Mailing Address - Phone:808-625-6444
Mailing Address - Fax:808-623-2552
Practice Address - Street 1:95-1249 MEHEULA PKWY
Practice Address - Street 2:UNIT 187
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-1779
Practice Address - Country:US
Practice Address - Phone:808-625-6444
Practice Address - Fax:808-623-2552
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-7573207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI6539444OtherUHA
HI00A0089803OtherHMSA
HIE93346Medicare UPIN
HI6539444OtherUHA