Provider Demographics
NPI:1881647782
Name:LERNER, STUART DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:DAVID
Last Name:LERNER
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 1:970 N KALAHEO AVE STE C316
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-1883
Mailing Address - Country:US
Mailing Address - Phone:808-954-4463
Mailing Address - Fax:888-364-2014
Practice Address - Street 1:970 N KALAHEO AVE STE C316
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-1883
Practice Address - Country:US
Practice Address - Phone:808-954-4463
Practice Address - Fax:888-364-2014
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI6750207P00000X
HIMD-6750207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI05844207Medicaid
HI05844207Medicaid
HICY729XMedicare PIN