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Individual

DR. ETHAN THACHER ROUTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2226 LILIHA ST STE 302, HONOLULU, HI 96817-1605
(808) 585-8008
Mailing address
2226 LILIHA ST STE 302, HONOLULU, HI 96817-1605
(808) 585-8008

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
MD-20864
HI
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
MD-20864
HI

Other

Enumeration date
04/25/2015
Last updated
10/02/2020
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