Individual
DR. JOHN STANLEY WICHMANN-WALCZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
94-837 WAIPAHU ST, WAIPAHU, HI 96797-3320
(808) 671-3911
(808) 677-2720
Mailing address
94-837 WAIPAHU ST, WAIPAHU, HI 96797-3320
(808) 671-3911
(808) 677-2720
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
MD2647
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00E001467-9
HMSA PROVIDER NUMBER
HI
05
—
013771-03
—
HI
01
—
151218
MEDICARE PIN NUMBER
—
Enumeration date
08/22/2005
Last updated
12/27/2018
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