Organization
DUKE E. WAGNER,PH.D.,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DUKE ELVIN WAGNER PH.D. (PRESIDENT)
(808) 254-5468
Entity
Organization
Contact information
Practice address
970 N KALAHEO AVE, A204, KAILUA, HI 96734-1801
(808) 254-5468
(808) 262-4437
Mailing address
PO BOX 2192, PEARL CITY, HI 96782-9192
(808) 254-5468
(808) 262-4437
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY298
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000003889
HMSA
HI
05
—
00461901
—
HI
Enumeration date
05/09/2007
Last updated
06/09/2008
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