Provider Demographics
NPI:1588839344
Name:STEVEN J BERMAN MD INC
Entity Type:Organization
Organization Name:STEVEN J BERMAN MD INC
Other - Org Name:HONOLULU BIOLOGICAL LABORATORY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORP SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEIDE
Authorized Official - Middle Name:JON
Authorized Official - Last Name:BERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-524-0066
Mailing Address - Street 1:1380 LUSITANA ST STE 810
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813
Mailing Address - Country:US
Mailing Address - Phone:808-524-0066
Mailing Address - Fax:808-524-3396
Practice Address - Street 1:1380 LUSITANA ST STE 810
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2444
Practice Address - Country:US
Practice Address - Phone:808-524-0066
Practice Address - Fax:808-524-3396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-23
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
HICARRIER #00833Medicare UPIN
HI0000WBCDGMedicare PIN