Provider Demographics
NPI:1891910469
Name:ELIASHOF, BYRON AMDUR (MD)
Entity Type:Individual
Prefix:
First Name:BYRON
Middle Name:AMDUR
Last Name:ELIASHOF
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 1:615 PIIKOI STREET
Mailing Address - Street 2:SUITE 1509
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-3142
Mailing Address - Country:US
Mailing Address - Phone:808-596-7800
Mailing Address - Fax:808-596-7803
Practice Address - Street 1:615 PIIKOI STREET
Practice Address - Street 2:SUITE 1509
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-3142
Practice Address - Country:US
Practice Address - Phone:808-596-7800
Practice Address - Fax:808-596-7803
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI15692084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI31583OtherHMSA
HI31583OtherHMSA
0000BBNWKMedicare ID - Type Unspecified