Provider Demographics
NPI:1750377404
Name:MEYER, JOHN HARLAN (MD, PHD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:HARLAN
Last Name:MEYER
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1329 LUSITANA ST
Mailing Address - Street 2:SUITE 705
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2429
Mailing Address - Country:US
Mailing Address - Phone:808-524-0400
Mailing Address - Fax:808-524-0402
Practice Address - Street 1:1329 LUSITANA ST
Practice Address - Street 2:SUITE 705
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2429
Practice Address - Country:US
Practice Address - Phone:808-524-0400
Practice Address - Fax:808-524-0402
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-9840207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIF11740Medicare UPIN