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NPI Code Detail

MEDICARE: DR. AUDIE ASISTIN MD

MEDICARE: DR. AUDIE ASISTIN MD
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
1207L00000XAnesthesiology PhysicianMD11318HI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
200B0227328OTHERHIHMSA BC BS

General Provider Information

NPI Number : 1457359861
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AUDIE ASISTIN MD
Provider Business Mailing Address
First Line : PO BOX 700309
Second Line :
City : KAPOLEI
State : HI
Zip : 96709-0309
Country : US
Telephone Number : 808-203-7943
Fax Number : 808-693-8060
Provider Business Practice Location Address
First Line : 91-2141 FORT WEAVER RD
Second Line :
City : EWA BEACH
State : HI
Zip : 96706-1993
Country : US
Telephone Number : 808-678-7400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2005
Last Update Date : 10/20/2021

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