Healthcare Provider Details

I. General information

NPI: 1396927323
Provider Name (Legal Business Name): WERNER H. GREBE, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2007
Last Update Date: 11/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98-1079 MOANALUA RD STE 580
AIEA HI
96701-4716
US

IV. Provider business mailing address

98-1079 MOANALUA RD STE 580
AIEA HI
96701-4716
US

V. Phone/Fax

Practice location:
  • Phone: 808-488-7797
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number3282
License Number StateHI

VIII. Authorized Official

Name: DR. WERNER HARTMUT GREBE
Title or Position: PHYSICIAN/ PRESIDENT
Credential: M.D.
Phone: 808-488-7797