1346276052 NPI number — DR. ERIC HOWARD KLEMMER M.D.

Table of content: DR. ERIC HOWARD KLEMMER M.D. (NPI 1346276052)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346276052 NPI number — DR. ERIC HOWARD KLEMMER M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KLEMMER
Provider First Name:
ERIC
Provider Middle Name:
HOWARD
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KLEMMER
Provider Other First Name:
HOWIE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1346276052
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/29/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
770 KAPIOLANI BLVD
Provider Second Line Business Mailing Address:
#705
Provider Business Mailing Address City Name:
HONOLULU
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96813-5212
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-597-8791
Provider Business Mailing Address Fax Number:
808-597-8781

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1301 PUNCHBOWL ST
Provider Second Line Business Practice Location Address:
EMERGENCY DEPT. QUEEN'S MEDICAL CENTER
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96813-2402
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-597-8791
Provider Business Practice Location Address Fax Number:
808-597-8781
Provider Enumeration Date:
06/24/2006

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: 207P00000X , with the licence number:  MD10168 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 00235101 , issued by the state of ( HI ) . This identifiers is of the category "MEDICAID".