Organization
PEDIATRIC PROFESSIONALS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WALLACE J MATTHEWS JR. M.D. (PRESIDENT)
(808) 593-9944
Entity
Organization
Contact information
Practice address
1350 S KING ST STE 300, HONOLULU, HI 96814-2066
(808) 593-9944
(808) 593-0565
Mailing address
1350 S KING ST STE 300, HONOLULU, HI 96814-2066
(808) 593-9944
(808) 593-0565
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD4255
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000004481
QHMS 2
HI
01
—
00519101
DSS
HI
05
—
00519101
—
HI
01
—
02534679801
UHA
HI
01
—
04481
HMSA 2
HI
01
—
192509
HMAI
HI
01
—
J4489
HMSA
HI
01
—
MD4255-01
QHCP
HI
Enumeration date
03/22/2007
Last updated
08/22/2020
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