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Individual

DR. ROGER D FELLOWS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
67-1125 MAMALAHOA HWY, KAMUELA, HI 96743-8496
(808) 881-4881
Mailing address
68-1375 S PAUOA RD APT Q1, KAMUELA, HI 96743-8726
(808) 885-7025
(808) 885-7025

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
149047-1205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03831
UT
Enumeration date
09/29/2005
Last updated
03/22/2009
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