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General NPI Number Information
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NPI Number | 1982094975
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Entity Type | Organization
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Legal Business Name | ROY M MATSUYAMA MD LLC
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Dates
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Enumeration Date | 01/28/2015
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Last Update Date | 02/02/2015
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Provider Practice Location Address
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Address Line | 173 HOOHANA ST SUITE 104
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City | KAHULUI
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State | HI
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Zip | 96732-2482
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Country | US
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Telephone | 808-871-7222
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Fax | 808-871-2222
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Provider Business Mailing Address
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Address Line | 173 HOOHANA ST SUITE 104
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City | KAHULUI
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State | HI
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Zip | 96732-2482
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Country | US
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Telephone | 808-871-7222
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Fax | 808-871-2222
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Authorized Official
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Title or Position | OWNER
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Name | ROY M MATSUYAMA
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Credential | MD
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Telephone | 808-871-7222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 17851
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License Number State | HI
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