Organization
BRIAN I. WATANABE, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN I. WATANABE M.D. (PRESIDENT / OWNER)
(808) 244-6776
Entity
Organization
Contact information
Practice address
1885 MAIN ST, SUITE 205, WAILUKU, HI 96793-1819
(808) 244-6776
(808) 244-6005
Mailing address
PO BOX 308, WAILUKU, HI 96793-0308
(808) 244-6776
(808) 244-6005
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD-7581
HI
2086S0129X
Vascular Surgery Physician
Primary
MD-7581
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OOG834232
—
CA
Enumeration date
09/22/2008
Last updated
09/22/2008
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