Healthcare Provider Details

I. General information

NPI: 1780902577
Provider Name (Legal Business Name): WERNER G. SCHROFFNER, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2010
Last Update Date: 05/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1380 LUSITANA ST SUITE 902
HONOLULU HI
96813-2449
US

IV. Provider business mailing address

1380 LUSITANA STREET SUITE 902
HONOLULU HI
96813-2449
US

V. Phone/Fax

Practice location:
  • Phone: 808-524-2472
  • Fax: 808-537-5698
Mailing address:
  • Phone: 808-524-2472
  • Fax: 808-537-5698

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. WERNER G SCHROFFNER
Title or Position: OWNER
Credential: M.D.
Phone: 808-524-2472