Organization
ROBERT D IRVINE, MD, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT DAILEY IRVINE M.D. (PRESIDENT)
(808) 935-5465
Entity
Organization
Contact information
Practice address
670 PONAHAWAI ST, STE 115, HILO, HI 96720-2660
(808) 935-5465
(808) 935-5467
Mailing address
670 PONAHAWAI ST, STE 115, HILO, HI 96720-2660
(808) 935-5465
(808) 935-5467
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
MD2284
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000036673
HAWAII MEDICAL SERVICES ASSOCIATION
HI
05
—
03316401
—
HI
Enumeration date
09/22/2009
Last updated
09/22/2009
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