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Individual

TED J. WATANABE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
347 N KUAKINI ST, HONOLULU, HI 96817-2306
(808) 522-0190
(808) 523-9068
Mailing address
321 N KUAKINI ST, SUITE 405, HONOLULU, HI 96817-2364
(808) 522-0190
(808) 523-9068

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD3504
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0001215402
HI
05
0001215403
HI
01
0012773
QUEST HMSA
HI
01
00J0012771
QUEST HMSA
HI
01
012154-02
ST DEPT OF PUB SAFETY
HI
01
012154-03
ST DEPT OF PUB SAFETY
HI
01
1082145098
AETNA
HI
01
20124380
US DEPT OF LABOR
HI
01
300017130
PALMETTO GBA
HI
01
990157698-96817-E006
TRICARE
HI
01
990157698002
HAWAII ELECTRICIANS
HI
01
99015769896701B006
WEST REGION CLAIMS (WPS)
HI
01
J012771
QUEST HMSA
HI
01
MD3504
QUEST-QUEENS HAWAII CARE
HI
Enumeration date
04/17/2006
Last updated
02/07/2017
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