Healthcare Provider Details

I. General information

NPI: 1104153121
Provider Name (Legal Business Name): JOHN HARLAN MEYER MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2009
Last Update Date: 10/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1329 LUSITANA ST SUITE 705
HONOLULU HI
96813-2429
US

IV. Provider business mailing address

1329 LUSITANA ST SUITE 705
HONOLULU HI
96813-2429
US

V. Phone/Fax

Practice location:
  • Phone: 808-524-0400
  • Fax: 808-524-0402
Mailing address:
  • Phone: 808-524-0400
  • Fax: 808-524-0402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberMD-9840
License Number StateHI

VIII. Authorized Official

Name: DR. JOHN HARLAN MEYER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 808-524-0400