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Organization

ROBERT L. PETERSON, INC.

Active
Other names
Athena Group
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ROBERT L PETERSON M.D. (OWNER)
(808) 944-8551
Entity
Organization

Contact information

Practice address
1319 PUNAHOU ST, #1070, HONOLULU, HI 96826-1001
(808) 944-8557
(808) 955-5667
Mailing address
1319 PUNAHOU ST, #1070, HONOLULU, HI 96826-1001
(808) 944-8557
(808) 955-5667

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
MD7087
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
91264
BLUE CROSS BLUE SHEILD
HI
05
91264
HI
01
MD7087
QUEENS HEALTH CARE
HI
Enumeration date
05/20/2006
Last updated
08/22/2020
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