Healthcare Provider Details

I. General information

NPI: 1831197813
Provider Name (Legal Business Name): JOSEPH WILLIAM CHAMBERS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2005
Last Update Date: 06/12/2020
Certification Date: 06/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 MAHALANI STREET PHYSICIAN PRACTICE SERVICES
WAILUKU HI
96793-2526
US

IV. Provider business mailing address

221 MAHALANI STREET PHYSICIAN PRACTICE SERVICES
WAILUKU HI
96793-2526
US

V. Phone/Fax

Practice location:
  • Phone: 808-442-5649
  • Fax: 808-442-5651
Mailing address:
  • Phone: 808-442-5649
  • Fax: 808-442-5651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD21997
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD15901
License Number StateHI
# 3
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD22994
License Number StateWA
# 4
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberMD15901
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: