Provider Demographics
NPI:1407866973
Name:HOWARD G. BARBAROSH MD INC
Entity Type:Organization
Organization Name:HOWARD G. BARBAROSH MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER SECT OF CORPORATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:TODDIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BARBAROSH
Authorized Official - Suffix:
Authorized Official - Credentials:RN JD
Authorized Official - Phone:808-244-6266
Mailing Address - Street 1:1887 WILI PA LOOP
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793
Mailing Address - Country:US
Mailing Address - Phone:808-244-6266
Mailing Address - Fax:808-244-6781
Practice Address - Street 1:1887 WILI PA LOOP
Practice Address - Street 2:SUITE 1
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793
Practice Address - Country:US
Practice Address - Phone:808-244-6266
Practice Address - Fax:808-244-6781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD7698207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI529828-01Medicaid
HIH51915Medicare ID - Type Unspecified
H51916Medicare PIN
HIA40144Medicare UPIN