Individual
SAMUEL ERNEST WILLIAM JOHNSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
180 DICKENSON ST STE 103, LAHAINA, HI 96761-1215
(808) 214-5985
(808) 214-6766
Mailing address
180 DICKENSON ST STE 103, LAHAINA, HI 96761-1215
(808) 214-5985
(808) 214-6766
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD12422
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00C0241160
HMSA
HI
01
—
824532282
UHA
HI
05
—
824532282
—
HI
Enumeration date
07/19/2006
Last updated
10/02/2018
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