Healthcare Provider Details

I. General information

NPI: 1659370716
Provider Name (Legal Business Name): EDWARD JOSEPH MORGAN III PHD, MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 07/08/2007
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 Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number3576
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: