Healthcare Provider Details

I. General information

NPI: 1447363452
Provider Name (Legal Business Name): RODERICK DANIEL MORGANN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 02/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 S BERETANIA ST STE 401
HONOLULU HI
96813-2496
US

IV. Provider business mailing address

550 S BERETANIA ST STE 401
HONOLULU HI
96813-2496
US

V. Phone/Fax

Practice location:
  • Phone: 808-691-7744
  • Fax: 808-691-4005
Mailing address:
  • Phone: 808-691-7744
  • Fax: 808-691-4005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD-18784
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME 54481
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: