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Individual

BRIAN PETERNELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
81 MAKAWAO AVE STE 204, MAKAWAO, HI 96768-8859
(808) 213-0613
Mailing address
PO BOX 1325, MAKAWAO, HI 96768-1325
(808) 213-0613

Taxonomy

Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
20A13464
CA
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
DOS-2186
HI
208D00000X
General Practice Physician
20A13464
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DOS-2186
STATE OF HAWAII
HI
Enumeration date
05/24/2012
Last updated
02/04/2023
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