Healthcare Provider Details

I. General information

NPI: 1972692929
Provider Name (Legal Business Name): JOSHUA PIERCE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 12/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

134 PUUHONU WAY APT B
HILO HI
96720-2066
US

IV. Provider business mailing address

73 PUUHONU PL
HILO HI
96720-2060
US

V. Phone/Fax

Practice location:
  • Phone: 808-961-0655
  • Fax: 808-935-0904
Mailing address:
  • Phone: 808-934-2009
  • Fax: 808-934-2041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD12741
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: