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General NPI Number Information
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NPI Number | 1700373974
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Entity Type | Individual
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Provider Name | YEVIN ALAN ROH MD (AS OF JUNE 2018)
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Gender | Male
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Dates
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Enumeration Date | 04/13/2018
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Last Update Date | 08/18/2023
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Provider Practice Location Address
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Address Line | MCBH BRANCH HEALTH CLINIC 6905 HARRIS AVE,
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City | KAILUA
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State | HI
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Zip | 96734
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Country | US
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Telephone | 808-257-3365
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Fax |
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Provider Business Mailing Address
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Address Line | MCBH BRANCH HEALTH CLINIC 6905 HARRIS AVE
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City | KAILUA
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State | HI
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Zip | 96734
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Country | US
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Telephone |
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Fax |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 0101267478
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License Number State | VA
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