Provider Demographics
NPI:1255351730
Name:SOWERS, NATHALIE E (DPM)
Entity type:Individual
Prefix:DR
First Name:NATHALIE
Middle Name:E
Last Name:SOWERS
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:932 WARD AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-2131
Mailing Address - Country:US
Mailing Address - Phone:808-942-3644
Mailing Address - Fax:808-955-7950
Practice Address - Street 1:932 WARD AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-2131
Practice Address - Country:US
Practice Address - Phone:808-942-3644
Practice Address - Fax:808-955-7950
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPO-152213E00000X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI52987801Medicaid
HIU90209Medicare UPIN
HI52987801Medicaid