Healthcare Provider Details

I. General information

NPI: 1750577433
Provider Name (Legal Business Name): RAQUEL T BUSER MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2007
Last Update Date: 09/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1319 PUNAHOU ST
HONOLULU HI
96826-1001
US

IV. Provider business mailing address

PO BOX 25490
HONOLULU HI
96825-0490
US

V. Phone/Fax

Practice location:
  • Phone: 808-983-6000
  • Fax:
Mailing address:
  • Phone: 808-536-0314
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number14154
License Number StateHI

VIII. Authorized Official

Name: RAQUEL T BUSER
Title or Position: OWNER
Credential: MD
Phone: 808-536-0300