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General NPI Number Information
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NPI Number | 1790032340
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Entity Type | Organization
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Legal Business Name | STUART LERNER, M.D. LLC
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Dates
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Enumeration Date | 08/13/2012
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Last Update Date | 10/22/2021
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Provider Practice Location Address
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Address Line | 970 N KALAHEO AVE STE C316
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City | KAILUA
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State | HI
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Zip | 96734-1883
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Country | US
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Telephone | 180-895-4446
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Fax |
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Provider Business Mailing Address
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Address Line | 970 N KALAHEO AVE STE C316
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City | KAILUA
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State | HI
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Zip | 96734-1883
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Country | US
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Telephone | 180-895-4446
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MARYANNE MCCLOSKEY
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Credential |
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Telephone | 808-954-4463
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD-6750
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License Number State | HI
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