Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 170100000X | Medical Geneticist | 990358977 | HI |
Y | 207R00000X | Internist | MD-11685 | HI |
Y | 111NI0900X | Internist | MD-11685 | HI |
NPI | 1285639971 |
---|---|
Provider Name | Mary Linda Paul |
First Address | Waimea, HI 96796-0669 |
Second Address | Kalaheo, HI 96741 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2005 |
Last Update Date | 21/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
50008403 | (05) | HI |
F26259 | (02) | HI |