Provider Demographics
NPI:1174960728
Name:ANDREW, DAVID JOHNSON (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JOHNSON
Last Name:ANDREW
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1583 HOAAINA ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96821-1311
Mailing Address - Country:US
Mailing Address - Phone:808-373-8820
Mailing Address - Fax:808-373-8820
Practice Address - Street 1:1583 HOAAINA ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96821-1311
Practice Address - Country:US
Practice Address - Phone:808-373-8820
Practice Address - Fax:808-373-8820
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-22
Last Update Date:2013-05-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
HI1384207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI1384OtherHAWAII MEDICAL LICENSE