Healthcare Provider Details

I. General information

NPI: 1649453655
Provider Name (Legal Business Name): EDWARD Y C HEW MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2007
Last Update Date: 03/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1712 LILIHA ST SUITE 103
HONOLULU HI
96817-5410
US

IV. Provider business mailing address

PO BOX 61353
HONOLULU HI
96839-1353
US

V. Phone/Fax

Practice location:
  • Phone: 808-545-8361
  • Fax:
Mailing address:
  • Phone: 808-545-8361
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License NumberMD4773
License Number StateHI

VIII. Authorized Official

Name: EDWARD Y C HEW
Title or Position: PHYSICIAN
Credential: MD
Phone: 808-545-8361