Provider Demographics
NPI:1942315775
Name:GROTE, JOSEPH A (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:A
Last Name:GROTE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1099 ALAKEA ST
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-4511
Mailing Address - Country:US
Mailing Address - Phone:808-547-4600
Mailing Address - Fax:808-547-4559
Practice Address - Street 1:377 KEAHOLE ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96825-3405
Practice Address - Country:US
Practice Address - Phone:808-396-6675
Practice Address - Fax:808-395-2104
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HIMD2467207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI03411004Medicaid
HI03411004Medicaid
HID36134Medicare UPIN