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Individual

MATTHEW C DAVIES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1292 WAIANUENUE AVE, HILO, HI 96720-1228
(808) 934-4000
Mailing address
1292 WAIANUENUE AVE, HILO, HI 96720-1228
(808) 934-4000

Taxonomy

Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
D12345
CA
207Q00000X
Family Medicine Physician
Primary
DOS 1202
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000280743
HMSA BILLING NUMBER
HI
05
626369-02
HI
Enumeration date
05/17/2007
Last updated
01/07/2009
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