Healthcare Provider Details

I. General information

NPI: 1891895629
Provider Name (Legal Business Name): THORNTON VERN DILCHER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66-037 KAMEHAMEHA HWY STE 103
HALEIWA HI
96712-1415
US

IV. Provider business mailing address

66-037 KAMEHAMEHA HWY STE 103
HALEIWA HI
96712-1415
US

V. Phone/Fax

Practice location:
  • Phone: 808-637-7054
  • Fax: 808-637-7696
Mailing address:
  • Phone: 808-637-7054
  • Fax: 808-637-7696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number3100
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: