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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
Update your record

If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.

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