MEDICARE: DR. VICTOR VALCOUR M.D.

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	174400000X	Specialist	MD9863	HI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073554317
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VICTOR VALCOUR M.D.

Provider Business Mailing Address
First Line	:	677 ALA MOANA BLVD
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96813-5471
Country	:	US
Telephone Number	:	808-535-5975
Fax Number	:	808-535-5976

Provider Business Practice Location Address
First Line	:	3675 KILAUEA AVE
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96816-2333
Country	:	US
Telephone Number	:	808-737-2751
Fax Number	:	808-735-7047

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

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	08/15/2007

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