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Individual

PAUL W. GRANDON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
55 MAUI LANI PKWY, WAILUKU, HI 96793-2416
(808) 243-6050
Mailing address
55 MAUI LANI PKWY, WAILUKU, HI 96793-2416
(808) 243-6050

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
017275
LA
207R00000X
Internal Medicine Physician
Primary
MD-21227
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
017275
LICENSE
LA
05
1364738
LA
Enumeration date
01/31/2006
Last updated
07/25/2022
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