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General NPI Number Information
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NPI Number | 1578702007
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Entity Type | Organization
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Legal Business Name | LAWRENCE DERBES MD INC.
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Dates
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Enumeration Date | 02/05/2009
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Last Update Date | 08/08/2013
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Provider Practice Location Address
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Address Line | 64-1032 MAMALAHOA HWY SUITE 201
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City | KAMUELA
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State | HI
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Zip | 96743-8441
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Country | US
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Telephone | 808-333-5303
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Fax | 808-339-7425
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Provider Business Mailing Address
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Address Line | 64-1032 MAMALAHOA HWY SUITE 201
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City | KAMUELA
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State | HI
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Zip | 96743-8441
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Country | US
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Telephone | 808-333-5303
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Fax | 808-339-7425
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LAWRENCE J DERBES JR.
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Credential | M.D.
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Telephone | 808-954-1327
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | MD12544
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License Number State | HI
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