Healthcare Provider Details

I. General information

NPI: 1134330830
Provider Name (Legal Business Name): EDWARD J. MORGAN, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2046 MOTT-SMITH DR
HONOLULU HI
96822-2510
US

IV. Provider business mailing address

PO BOX 61730
HONOLULU HI
96839-1730
US

V. Phone/Fax

Practice location:
  • Phone: 808-536-7980
  • Fax: 808-536-7980
Mailing address:
  • Phone: 808-536-7980
  • Fax: 808-536-7980

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number551
License Number StateHI

VIII. Authorized Official

Name: EDWARD JOSEPH MORGAN III
Title or Position: PRESIDENT
Credential: M.D.
Phone: 808-536-7980