Organization
PETER A MATSUURA, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. WENDY A. MATSUURA MBA (ADMINISTRATOR)
(808) 969-3331
Entity
Organization
Contact information
Practice address
670 PONAHAWAI ST STE 214, HILO, HI 96720-7830
(808) 969-3331
(808) 935-6175
Mailing address
670 PONAHAWAI ST STE 214, HILO, HI 96720-7830
(808) 969-3331
(808) 935-6175
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD-9105
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
076295
—
HI
01
—
203794
HMSA
HI
Enumeration date
04/25/2017
Last updated
04/25/2017
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