Healthcare Provider Details

I. General information

NPI: 1467133066
Provider Name (Legal Business Name): RONALD G PERRY, MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2023
Last Update Date: 07/31/2023
Certification Date: 07/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1314 S KING ST STE 1151
HONOLULU HI
96814-1945
US

IV. Provider business mailing address

1314 S KING ST STE 1151
HONOLULU HI
96814-1945
US

V. Phone/Fax

Practice location:
  • Phone: 808-946-4541
  • Fax: 808-946-8088
Mailing address:
  • Phone: 808-946-4541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: MRS. QUYEN V JULIUSBURGER
Title or Position: BILLER / MANAGER
Credential: OFFICE MANAGER
Phone: 808-206-6456