Provider Demographics
NPI:1740253327
Name:LEDERER, JOHN L (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:L
Last Name:LEDERER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2226 LILIHA ST
Mailing Address - Street 2:STE 210
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-1605
Mailing Address - Country:US
Mailing Address - Phone:808-744-6187
Mailing Address - Fax:808-744-6958
Practice Address - Street 1:1650 LILIHA ST
Practice Address - Street 2:SUITE 105
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-3169
Practice Address - Country:US
Practice Address - Phone:808-524-3131
Practice Address - Fax:808-524-3189
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2018-06-06
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Provider Licenses
StateLicense IDTaxonomies
HI66812085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI05532906Medicaid
HIF63724OtherHMSA
HIF63724OtherHMSA
HIH56638Medicare PIN