Provider Demographics
NPI:1336242791
Name:COLLORI, PETER G (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:G
Last Name:COLLORI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6600 KALANIANAOLE HWY
Mailing Address - Street 2:#225
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96825-1281
Mailing Address - Country:US
Mailing Address - Phone:808-394-2800
Mailing Address - Fax:808-394-2826
Practice Address - Street 1:6600 KALANIANAOLE HWY
Practice Address - Street 2:#225
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96825-1281
Practice Address - Country:US
Practice Address - Phone:808-394-2800
Practice Address - Fax:808-394-2826
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD13562084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIMD1356OtherQHCP
HIH101376Medicare PIN
HIMD1356OtherQHCP