Healthcare Provider Details

I. General information

NPI: 1376837997
Provider Name (Legal Business Name): DUERLER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2011
Last Update Date: 09/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

64-1032 MAMALAHOA HWY SUITE 306
KAMUELA HI
96743
US

IV. Provider business mailing address

64-1032 MAMALAHOA HWY SUITE 306
KAMUELA HI
96743
US

V. Phone/Fax

Practice location:
  • Phone: 808-769-5010
  • Fax: 808-769-5208
Mailing address:
  • Phone: 808-769-5010
  • Fax: 808-769-5208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. TIMOTHY DUERLER
Title or Position: PRESIDENT
Credential: MD
Phone: 808-351-6836