Provider Demographics
NPI:1881074391
Name:ENT SPECIALISTS OF HAWAII
Entity type:Organization
Organization Name:ENT SPECIALISTS OF HAWAII
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:EDMOND
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-542-4009
Mailing Address - Street 1:64-0135 MAMALAHOA HWY
Mailing Address - Street 2:STE J
Mailing Address - City:KAMUELA
Mailing Address - State:HI
Mailing Address - Zip Code:96743
Mailing Address - Country:US
Mailing Address - Phone:808-887-0706
Mailing Address - Fax:808-887-1878
Practice Address - Street 1:64-0135 MAMALAHOA HWY
Practice Address - Street 2:STE J
Practice Address - City:KAMUELA
Practice Address - State:HI
Practice Address - Zip Code:96743
Practice Address - Country:US
Practice Address - Phone:808-887-0706
Practice Address - Fax:808-887-1878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-01
Last Update Date:2015-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI18051261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI1750336244Medicare UPIN