Provider Demographics
NPI:1942286067
Name:HARPER, IRVING W III (MD)
Entity Type:Individual
Prefix:
First Name:IRVING
Middle Name:W
Last Name:HARPER
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1366
Mailing Address - Street 2:
Mailing Address - City:HONOKAA
Mailing Address - State:HI
Mailing Address - Zip Code:96727-1366
Mailing Address - Country:US
Mailing Address - Phone:716-299-8570
Mailing Address - Fax:855-954-0016
Practice Address - Street 1:161 WAILEA IKE PL STE A104
Practice Address - Street 2:
Practice Address - City:WAILEA
Practice Address - State:HI
Practice Address - Zip Code:96753-6502
Practice Address - Country:US
Practice Address - Phone:808-874-5141
Practice Address - Fax:808-875-1173
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-20
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HIMD - 12617207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HHCMedicare ID - Type Unspecified
E50027Medicare UPIN