Provider Demographics
NPI:1972692929
Name:PIERCE, JOSHUA (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:
Last Name:PIERCE
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 1:73 PUUHONU PL
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-2060
Mailing Address - Country:US
Mailing Address - Phone:808-934-2009
Mailing Address - Fax:808-934-2041
Practice Address - Street 1:134 PUUHONU WAY APT B
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2066
Practice Address - Country:US
Practice Address - Phone:808-961-0655
Practice Address - Fax:808-935-0904
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD12741208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI553330-02Medicaid
HI0000247080OtherHMSA BCBS
HIH102684Medicare PIN
HI553330-02Medicaid