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NPI Code Detail

MEDICARE: CLELAND G. CHILD M.D.

MEDICARE: CLELAND G. CHILD 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
1207R00000XInternal Medicine Physician24360HI

General Provider Information

NPI Number : 1548242076
Entity Type Code : Individual
Provider Name (Legal Business Name) : CLELAND G. CHILD M.D.
Provider Business Mailing Address
First Line : 888 S KING ST
Second Line :
City : HONOLULU
State : HI
Zip : 96813-3097
Country : US
Telephone Number : 770-400-7700
Fax Number :
Provider Business Practice Location Address
First Line : 888 S KING ST
Second Line :
City : HONOLULU
State : HI
Zip : 96813-3097
Country : US
Telephone Number : 808-582-1331
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2005
Last Update Date : 11/15/2024

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