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General NPI Number Information
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NPI Number | 1245394543
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Entity Type | Individual
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Provider Name | GEORGE HERBERT SEBERG JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 01/30/2019
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Provider Practice Location Address
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Address Line | 850 W HIND DR STE 109
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City | HONOLULU
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State | HI
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Zip | 96821-1845
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Country | US
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Telephone | 808-373-5728
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Fax | 808-377-3432
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Provider Business Mailing Address
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Address Line | 2324 NUUANU AVE
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City | HONOLULU
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State | HI
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Zip | 96817-1714
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Country | US
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Telephone | 808-536-3222
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Fax | 808-545-3099
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD-3219
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License Number State | HI
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