Healthcare Provider Details

I. General information

NPI: 1881074391
Provider Name (Legal Business Name): ENT SPECIALISTS OF HAWAII
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2015
Last Update Date: 06/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

64-0135 MAMALAHOA HWY STE J
KAMUELA HI
96743
US

IV. Provider business mailing address

64-0135 MAMALAHOA HWY STE J
KAMUELA HI
96743
US

V. Phone/Fax

Practice location:
  • Phone: 808-887-0706
  • Fax: 808-887-1878
Mailing address:
  • Phone: 808-887-0706
  • Fax: 808-887-1878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number18051
License Number StateHI

VIII. Authorized Official

Name: DR. PAUL EDMOND HOWARD
Title or Position: OWNER
Credential: MD
Phone: 302-542-4009