Provider Demographics
NPI:1982660544
Name:WAI, PETER C H (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:C H
Last Name:WAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 PUNCHBOWL ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2499
Mailing Address - Country:US
Mailing Address - Phone:808-691-1000
Mailing Address - Fax:808-533-3800
Practice Address - Street 1:1301 PUNCHBOWL ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2499
Practice Address - Country:US
Practice Address - Phone:808-691-1000
Practice Address - Fax:808-533-3800
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-24
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD5343207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD5343OtherQUEENS HEALTHCARE MDX
00J002393OtherFEDERAL EMPLOYEE PLAN
0216250OtherPHARMACY BENEFIT MNGMENT
00J002393OtherHMSA
HI02162501Medicaid
0402865OtherMEDCO UNITED HEALTHCARE
00J002393OtherBLUE CARE
H0000BDMRQMedicare ID - Type Unspecified
00J002393OtherHMSA