Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0204X | Pediatric Emergency Doctor | MD-3186 | HI |
NPI | 1306956461 |
---|---|
Provider Name | Dr. Rodney Brian Boychuk |
First Address | Honolulu, HI 96826-1001 |
Second Address | Honolulu, HI 96826-1001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 21/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E64702 | (02) | HI |