Individual
DR. GLENN MICHAEL WASSERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, MPH
Contact information
Practice address
1250 PUNCHBOWL ST, ROOM 423, HONOLULU, HI 96813-2416
(800) 858-6458
Mailing address
47-507 KINANA WAY, KANEOHE, HI 96744-5414
(808) 239-7213
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD-5316
HI
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
MD-5316
HI
2083X0100X
Occupational Medicine Physician
MD-5316
HI
Other
Enumeration date
09/26/2007
Last updated
09/26/2007
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