1376593269 NPI number — GARRY PEERS MD

Table of content: GARRY PEERS MD (NPI 1376593269)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376593269 NPI number — GARRY PEERS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PEERS
Provider First Name:
GARRY
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1376593269
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/23/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1329 LUSITANA ST
Provider Second Line Business Mailing Address:
SUITE 506
Provider Business Mailing Address City Name:
HONOLULU
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96813-2431
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-599-7779
Provider Business Mailing Address Fax Number:
808-599-7780

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1329 LUSITANA ST
Provider Second Line Business Practice Location Address:
SUITE 506
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96813-2431
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-599-7779
Provider Business Practice Location Address Fax Number:
808-599-7780
Provider Enumeration Date:
05/11/2006

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: 208800000X , with the licence number:  MD11120 , 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: AQ992Z . This is a "PTAN" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 496457-02 , issued by the state of ( HI ) . This identifiers is of the category "MEDICAID".
  • Identifier: MD11120 . This is a "HAWAII LICENSE NUMBER" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com