Provider Demographics
NPI:1467464628
Name:TAW, HARRY T A (MD)
Entity Type:Individual
Prefix:
First Name:HARRY
Middle Name:T A
Last Name:TAW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1575 SOUTH BERETANIA STREEET
Mailing Address - Street 2:#201 202
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-1149
Mailing Address - Country:US
Mailing Address - Phone:808-946-1712
Mailing Address - Fax:808-946-1728
Practice Address - Street 1:1575 SOUTH BERETANIA STREEET
Practice Address - Street 2:#201 202
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-1149
Practice Address - Country:US
Practice Address - Phone:808-946-1712
Practice Address - Fax:808-946-1728
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI4467207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIB10625OtherHMSA
HI01023001Medicaid
HI0000BDJPMMedicare ID - Type Unspecified
E10534Medicare UPIN