Healthcare Provider Details

I. General information

NPI: 1689767527
Provider Name (Legal Business Name): ROY T NAKAYAMA MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 10/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1319 PUNAHOU ST STE 824
HONOLULU HI
96826-1032
US

IV. Provider business mailing address

PO BOX 25370
HONOLULU HI
96825-0370
US

V. Phone/Fax

Practice location:
  • Phone: 808-956-7457
  • Fax:
Mailing address:
  • Phone: 808-536-0314
  • Fax: 808-536-0320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number2692
License Number StateHI

VIII. Authorized Official

Name: ROY T NAKAYAMA
Title or Position: OWNER
Credential: M.D.
Phone: 808-956-7457