Provider Demographics
NPI:1396946067
Name:PETER J DEE MD INC
Entity type:Organization
Organization Name:PETER J DEE MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF INTERNAL MEDICINE PSYCHIA
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:J
Authorized Official - Last Name:DEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-531-0022
Mailing Address - Street 1:1520 LILIHA STREET
Mailing Address - Street 2:#501
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-3564
Mailing Address - Country:US
Mailing Address - Phone:808-531-0022
Mailing Address - Fax:808-531-0023
Practice Address - Street 1:1520 LILIHA STREET
Practice Address - Street 2:#501
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-3564
Practice Address - Country:US
Practice Address - Phone:808-531-0022
Practice Address - Fax:808-531-0023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD03714207R00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI012112OtherHMSA
HI01158201Medicaid
H0000BDJTTMedicare ID - Type Unspecified
C98409Medicare UPIN