Provider Demographics
NPI:1609394543
Name:WARNER, HUNTER ROBERT EDWIN (LAT, ATC)
Entity Type:Individual
Prefix:
First Name:HUNTER
Middle Name:ROBERT EDWIN
Last Name:WARNER
Suffix:
Gender:M
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:WESTERLY
Mailing Address - State:RI
Mailing Address - Zip Code:02891-1948
Mailing Address - Country:US
Mailing Address - Phone:401-222-9662
Mailing Address - Fax:
Practice Address - Street 1:917 KALANIANAOLE HWY
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-4600
Practice Address - Country:US
Practice Address - Phone:401-222-9662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-30
Last Update Date:2017-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0010742081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine