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General NPI Number Information
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NPI Number | 1578941704
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Entity Type | Organization
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Legal Business Name | JENNY WELHAM, MD LLC
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Dates
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Enumeration Date | 05/07/2015
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Last Update Date | 05/18/2015
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Provider Practice Location Address
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Address Line | 1319 PUNAHOU ST STE 1140
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City | HONOLULU
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State | HI
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Zip | 96826-1001
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Country | US
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Telephone | 808-944-1844
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Fax | 808-947-9987
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Provider Business Mailing Address
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Address Line | 1319 PUNAHOU ST STE 1140
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City | HONOLULU
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State | HI
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Zip | 96826-1001
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Country | US
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Telephone | 808-944-1844
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Fax | 808-947-9987
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Authorized Official
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Title or Position | OWNER
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Name | JENNY HORITA WELHAM
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Credential | M.D.
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Telephone | 808-462-0023
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | MD-17885
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License Number State | HI
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