Provider Demographics
NPI:1891838934
Name:CARLOS WARTER M.D. P.C.
Entity Type:Organization
Organization Name:CARLOS WARTER M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:WARTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-732-6464
Mailing Address - Street 1:4211 WAIALAE AVE
Mailing Address - Street 2:SUITE 207
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-5306
Mailing Address - Country:US
Mailing Address - Phone:808-732-6464
Mailing Address - Fax:808-732-6433
Practice Address - Street 1:4211 WAIALAE AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-5306
Practice Address - Country:US
Practice Address - Phone:808-732-6464
Practice Address - Fax:808-732-6433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI129152084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0247163OtherHMSA
HI553538Medicaid
HIH56760Medicare ID - Type Unspecified
HII07687Medicare UPIN