Provider Demographics
NPI:1992827448
Name:HARMAN, MATTHEW MARTIN (PT)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:MARTIN
Last Name:HARMAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 OHUKAI RD STE C112
Mailing Address - Street 2:
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-7047
Mailing Address - Country:US
Mailing Address - Phone:808-879-2088
Mailing Address - Fax:808-879-2088
Practice Address - Street 1:300 OHUKAI RD STE C112
Practice Address - Street 2:
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-7047
Practice Address - Country:US
Practice Address - Phone:808-879-2088
Practice Address - Fax:808-879-2088
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1836225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH54494Medicare UPIN