Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0400X | Neurologist | MD-3975 | HI |
N | 2084N0600X | Clinical Neurophysiologist | MD-3975 | HI |
NPI | 1043277080 |
---|---|
Provider Name | Dr. Anthony J Mauro |
First Address | Honolulu, HI 96813-2429 |
Second Address | Honolulu, HI 96813-2429 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
04574801 | (05) | HI |
D36194 | (02) | HI |