MEDICARE: WILLIAM B MEINKE 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
1	207Q00000X	Family Medicine Physician	MD12517	RI
2	207Q00000X	Family Medicine Physician	MD-11434	HI

General Provider Information

NPI Number	:	1588750905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM B MEINKE MD

Provider Business Mailing Address
First Line	:	450 KILAUEA AVE STE 105
Second Line	:
City	:	HILO
State	:	HI
Zip	:	96720-3089
Country	:	US
Telephone Number	:	808-961-4071
Fax Number	:

Provider Business Practice Location Address
First Line	:	15-2866 PAHOA VILLAGE RD
Second Line	:
City	:	PAHOA
State	:	HI
Zip	:	96778-7720
Country	:	US
Telephone Number	:	808-965-9711
Fax Number	:

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

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	05/24/2019

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Directions to “ WILLIAM B MEINKE MD” Practice Location

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