Healthcare Provider Details

I. General information

NPI: 1336014083
Provider Name (Legal Business Name): MH PRIMARY CARE PLUS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2025
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

73 PUUHONU PL STE 101
HILO HI
96720-2060
US

IV. Provider business mailing address

73 PUUHONU PL STE 101
HILO HI
96720-2060
US

V. Phone/Fax

Practice location:
  • Phone: 808-733-5111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. THOMAS WEINER
Title or Position: PHYSICIAN
Credential: MD
Phone: 706-424-3542