Individual
DEBORAH MATHIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2180 MAIN ST, WAILUKU, HI 96793-1666
(808) 242-6464
(808) 243-2343
Mailing address
2180 MAIN ST, WAILUKU, HI 96793-1666
(808) 242-6464
(808) 243-2343
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
MD3419
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04102902
—
HI
05
—
04102903
—
HI
01
—
464543
UHA
HI
01
—
99017685996793B081
TRICARE CHAMPUS
HI
01
—
X45166
HMSAA - 65CP - HMSA QUEST
HI
Enumeration date
07/26/2006
Last updated
07/09/2007
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