Healthcare Provider Details

I. General information

NPI: 1942315775
Provider Name (Legal Business Name): JOSEPH A GROTE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 07/31/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

377 KEAHOLE ST
HONOLULU HI
96825-3405
US

IV. Provider business mailing address

1099 ALAKEA ST SUITE 1100
HONOLULU HI
96813-4511
US

V. Phone/Fax

Practice location:
  • Phone: 808-396-6675
  • Fax: 808-395-2104
Mailing address:
  • Phone: 808-547-4600
  • Fax: 808-547-4559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD2467
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: