Provider Demographics
NPI:1497815260
Name:HEW, EDWARD Y C (MD)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:Y C
Last Name:HEW
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:PO BOX 61353
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96839-1353
Mailing Address - Country:US
Mailing Address - Phone:808-545-8361
Mailing Address - Fax:808-545-2362
Practice Address - Street 1:1712 LILIHA ST
Practice Address - Street 2:SUITE 103
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-5409
Practice Address - Country:US
Practice Address - Phone:808-545-8361
Practice Address - Fax:808-545-2362
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HIMD4773207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIA039501Medicaid
HIA039501OtherHMSA BCBS
A92166Medicare UPIN
HIH54282Medicare PIN