Healthcare Provider Details

I. General information

NPI: 1407226657
Provider Name (Legal Business Name): PAUL MOROZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2015
Last Update Date: 09/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 PUNAHOU ST
HONOLULU HI
96826-1027
US

IV. Provider business mailing address

1310 PUNAHOU ST
HONOLULU HI
96826-1027
US

V. Phone/Fax

Practice location:
  • Phone: 808-951-3638
  • Fax: 808-951-3718
Mailing address:
  • Phone: 808-951-3638
  • Fax: 808-951-3718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License NumberMD-18338
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: