Provider Demographics
NPI:1386627875
Name:LATTIMER, D GARY (MD)
Entity Type:Individual
Prefix:DR
First Name:D
Middle Name:GARY
Last Name:LATTIMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1329 LUSITANA ST
Mailing Address - Street 2:SUITE 708
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2429
Mailing Address - Country:US
Mailing Address - Phone:808-537-5445
Mailing Address - Fax:808-537-1813
Practice Address - Street 1:1329 LUSITANA ST
Practice Address - Street 2:SUITE 708
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2429
Practice Address - Country:US
Practice Address - Phone:808-537-5445
Practice Address - Fax:808-537-1813
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2010-10-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
HIMD7092208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology