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Individual
WILLIAM FAGAN
Active
Individual
WILLIAM FAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC163
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
235226
HMSA - 65CP - HMSA QUEST
HI
05
—
54551901
—
HI
01
—
990176859
HMAA
HI
Enumeration date
07/19/2006
Last updated
09/09/2010
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