Provider Demographics
NPI:1487663696
Name:LUM, WAYNE YH (MD)
Entity Type:Individual
Prefix:MR
First Name:WAYNE
Middle Name:YH
Last Name:LUM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2228 LILIHA ST.
Mailing Address - Street 2:#302
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817
Mailing Address - Country:US
Mailing Address - Phone:808-533-4619
Mailing Address - Fax:808-537-1614
Practice Address - Street 1:2228 LILIHA ST.
Practice Address - Street 2:#302
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817
Practice Address - Country:US
Practice Address - Phone:808-533-4619
Practice Address - Fax:808-537-1614
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2024-03-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HI3304207R00000X
HIH109599207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000BDGJTMedicaid
HI03897201Medicaid
HID36181Medicare UPIN
HI0000BDGJTMedicaid