Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PE0004X | Emergency Medical Services | 09201 | MS |
Y | 207PE0004X | Emergency Medical Services | MD11409 | HI |
NPI | 1033191796 |
---|---|
Provider Name | Dr. Richard C. Weiland |
First Address | Kula, HI 96790-7450 |
Second Address | Kula, HI 96790-7450 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
563016 | (05) | HI |
C47944 | (02) | HI |