Provider Demographics
NPI:1184975831
Name:WAYNE K. NADAMOTO, M.D. ORTHOPEDIC SURGEON INC
Entity type:Organization
Organization Name:WAYNE K. NADAMOTO, M.D. ORTHOPEDIC SURGEON INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:K
Authorized Official - Last Name:NADAMOTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-538-1457
Mailing Address - Street 1:1520 LILIHA ST STE 303
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-3563
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1520 LILIHA ST STE 303
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-3563
Practice Address - Country:US
Practice Address - Phone:808-538-1457
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-20
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI3385207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00500401Medicaid
HI040578001OtherDMERC
HI201225600OtherFEDERAL
HI000000431-7OtherHMSA
HI00500401Medicaid