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Individual

DR. JON D GERDSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
67-1123 MAMALAHOA HWY, STE 128, KAMUELA, HI 96743-8451
(808) 887-6460
(808) 887-6441
Mailing address
67-1123 MAMALAHOA HWY, STE 128, KAMUELA, HI 96743-8451
(808) 887-6460
(808) 887-6441

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
5842
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02481501
HI
Enumeration date
09/28/2006
Last updated
07/08/2007
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