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General NPI Number Information
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NPI Number | 1518677244
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Entity Type | Organization
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Legal Business Name | BETTINA HAERER MD LLC
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Dates
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Enumeration Date | 12/05/2022
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Last Update Date | 12/05/2022
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Provider Practice Location Address
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Address Line | 3660 BALDWIN AVE
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City | MAKAWAO
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State | HI
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Zip | 96768-7503
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Country | US
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Telephone | 808-573-2233
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1388
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City | HAIKU
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State | HI
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Zip | 96708-1388
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Country | US
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Telephone | 808-264-1728
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. BETTINA HAERER
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Credential | MD
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Telephone | 808-264-1729
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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