Provider Demographics
NPI:1649453655
Name:EDWARD Y C HEW MD
Entity type:Organization
Organization Name:EDWARD Y C HEW MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:Y C
Authorized Official - Last Name:HEW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-545-8361
Mailing Address - Street 1:PO BOX 61353
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96839-1353
Mailing Address - Country:US
Mailing Address - Phone:808-545-8361
Mailing Address - Fax:
Practice Address - Street 1:1712 LILIHA ST
Practice Address - Street 2:SUITE 103
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-5410
Practice Address - Country:US
Practice Address - Phone:808-545-8361
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-12
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD4773207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIA039501Medicaid
HIA039501OtherHMSA BCBS
HIA039501Medicaid
HIH54281Medicare PIN