MEDICARE: TIMOTHY QUINN HOWARD PHYSICIAN ASSISTANT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	AMD251	HI

General Provider Information

NPI Number	:	1043201494
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY QUINN HOWARD PHYSICIAN ASSISTANT

Provider Business Mailing Address
First Line	:	1029 KAPAHULU AVE STE 503
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96816-1332
Country	:	US
Telephone Number	:	808-218-7889
Fax Number	:	808-218-7891

Provider Business Practice Location Address
First Line	:	1029 KAPAHULU AVE STE 503
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96816-1332
Country	:	US
Telephone Number	:	808-218-7889
Fax Number	:	808-218-7891

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2005
Last Update Date	:	09/24/2019

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