MEDICARE: UROLOGY CONSULTANT LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician	MD11351	HI

General Provider Information

NPI Number	:	1043256092
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UROLOGY CONSULTANT LLC

Provider Business Mailing Address
First Line	:	91-2139 FT. WEAVER RD.
Second Line	:	#205
City	:	EWA BEACH
State	:	HI
Zip	:	96706-3608
Country	:	US
Telephone Number	:	808-677-6787
Fax Number	:	808-677-6786

Provider Business Practice Location Address
First Line	:	91-2139 FT. WEAVER RD.
Second Line	:	#205
City	:	EWA BEACH
State	:	HI
Zip	:	96706-3608
Country	:	US
Telephone Number	:	808-677-6787
Fax Number	:	808-677-6786

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DAVID C WEI
Credential	:	MD
Telephone Number	:	808-677-6787

Provider Enumeration Date	:	06/20/2006
Last Update Date	:	11/30/2007

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