Individual
DR. JOHN T. WATABE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3288 MOANALUA RD, HONOLULU, HI 96819-1469
(808) 432-0000
Mailing address
3288 MOANALUA RD, HONOLULU, HI 96819-1469
(808) 432-0000
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD-7267
HI
2085R0202X
Diagnostic Radiology Physician
MD-7267
HI
2085R0204X
Vascular & Interventional Radiology Physician
Primary
MD-7267
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000214064
HMSA BILLING NUMBER
HI
05
—
087636-01
—
HI
Enumeration date
05/31/2006
Last updated
05/26/2021
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