1164658019 NPI number — DR. BENJAMIN STUART THOMAS MD, MSCI

Table of content: DR. BENJAMIN STUART THOMAS MD, MSCI (NPI 1164658019)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164658019 NPI number — DR. BENJAMIN STUART THOMAS MD, MSCI

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
THOMAS
Provider First Name:
BENJAMIN
Provider Middle Name:
STUART
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD, MSCI
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1164658019
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/27/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1670 MAKALOA ST STE 204-324
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HONOLULU
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96814-3232
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-531-7111
Provider Business Mailing Address Fax Number:
808-528-5507

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
500 ALA MOANA BLVD
Provider Second Line Business Practice Location Address:
TOWER 5, SUITE 300
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96813-4920
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-531-7111
Provider Business Practice Location Address Fax Number:
808-528-5507
Provider Enumeration Date:
06/05/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RI0200X , with the licence number:  2013015515 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RI0200X , with the licence number: MD-18023 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207R00000X , with the licence number: 073163 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 131423 C5 . This is a "ALOHA INFECTIOUS DISEASES" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".