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General NPI Number Information
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NPI Number | 1083769756
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Entity Type | Organization
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Legal Business Name | OAHU GASTROENTEROLOGY INC
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 05/10/2011
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Provider Practice Location Address
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Address Line | 405 N KUAKINI ST SUITE 1108
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City | HONOLULU
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State | HI
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Zip | 96817-6300
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Country | US
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Telephone | 808-548-6008
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Fax | 808-548-6006
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Provider Business Mailing Address
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Address Line | 111 HEKILI ST SUITE A, #398
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City | KAILUA
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State | HI
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Zip | 96734-2800
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Country | US
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Telephone | 808-741-4292
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Fax | 808-548-6006
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROLAND BOON CHUAN TER
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Credential | MD
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Telephone | 808-548-6008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | MD12308
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License Number State | HI
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