Provider Demographics
NPI:1184806184
Name:ALISTAIR INC
Entity type:Organization
Organization Name:ALISTAIR INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALISTAIR
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:BAIROS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-323-8180
Mailing Address - Street 1:PO BOX 670
Mailing Address - Street 2:
Mailing Address - City:KEALAKEKUA
Mailing Address - State:HI
Mailing Address - Zip Code:96750-0670
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:81-956 HALEKII ST
Practice Address - Street 2:
Practice Address - City:KEALAKEKUA
Practice Address - State:HI
Practice Address - Zip Code:96750-8104
Practice Address - Country:US
Practice Address - Phone:808-323-8180
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-30
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI1992751127OtherINDIVIDUAL NPI