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General NPI Number Information
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NPI Number | 1063025971
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Entity Type | Organization
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Legal Business Name | MAUI TRAUMA SURGEONS LLP
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Dates
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Enumeration Date | 08/28/2020
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Last Update Date | 07/30/2024
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Provider Practice Location Address
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Address Line | 1830 WELLS STREET, SUITE 101
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City | WAILUKU
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State | HI
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Zip | 96793
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Country | US
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Telephone | 808-856-4060
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Fax | 808-442-9670
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Provider Business Mailing Address
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Address Line | 1830 WELLS STREET, SUITE 101
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City | WAILUKU
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State | HI
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Zip | 96793
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Country | US
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Telephone | 808-856-4060
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Fax | 808-442-9670
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. BETH JARRETT
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Credential | MD
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Telephone | 808-280-8030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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