| NPI | 1730797598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL BRIAN WILKINSON Owner 808-782-6761 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207P00000X Emergency Medicine |
| 207R00000X Internal Medicine | |
| 261Q00000X | |
| 261QA1903X Clinic/Center, Ambulatory Surgical | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QC1800X | |
| 261QI0500X Clinic/Center, Infusion Therapy | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QP1100X Clinic/Center, Podiatric | |
| 261QP2300X Clinic/Center, Primary Care | |
| 261QP3300X Clinic/Center, Pain | |
| 261QR0208X Clinic/Center, Radiology, Mobile | |
| 261QU0200X Clinic/Center, Urgent Care | |
| Enumeration Date | 2020-07-17 |
| Last Update Date | 2020-08-31 |