Healthcare Provider Details

I. General information

NPI: 1548509953
Provider Name (Legal Business Name): HELGA FIEDERER LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2013
Last Update Date: 02/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 MAKAWAO AVE UNIT 102 A
PUKALANI HI
96788
US

IV. Provider business mailing address

PO BOX 790761
PAIA HI
96779-0761
US

V. Phone/Fax

Practice location:
  • Phone: 808-250-6709
  • Fax:
Mailing address:
  • Phone: 808-250-6709
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMAT 8004
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: