Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | MD-5880 | HI |
NPI | 1003951906 |
---|---|
Provider Name | Barbara J Bezdicek |
First Address | Wailuku, HI 96793-2531 |
Second Address | Wailuku, HI 96793-2531 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2007 |
Last Update Date | 10/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0000027953 | HMSA BILLING NUMBER (01) | HI |
025101-01 | (05) | HI |
C97331 | (02) | HI |