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General NPI Number Information
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NPI Number | 1962659714
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Entity Type | Organization
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Legal Business Name | THE WOMEN'S HEALTH CENTER OF MAUI, LLC
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Dates
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Enumeration Date | 08/23/2008
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Last Update Date | 07/21/2011
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Provider Practice Location Address
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Address Line | 30 N CHURCH ST SUITE 300
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City | WAILUKU
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State | HI
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Zip | 96793-1600
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Country | US
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Telephone | 808-242-9787
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Fax | 808-242-4518
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Provider Business Mailing Address
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Address Line | 30 N CHURCH ST SUITE 300
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City | WAILUKU
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State | HI
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Zip | 96793-1600
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Country | US
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Telephone | 808-242-9787
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Fax | 808-242-4518
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | DR. BENJAMIN J. BERRY
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Credential | MD.
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Telephone | 808-242-9787
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD10631
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License Number State | HI
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