Provider Demographics
NPI:1043256092
Name:UROLOGY CONSULTANT LLC
Entity type:Organization
Organization Name:UROLOGY CONSULTANT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:C
Authorized Official - Last Name:WEI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-677-6787
Mailing Address - Street 1:91-2139 FT. WEAVER RD.
Mailing Address - Street 2:#205
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-3608
Mailing Address - Country:US
Mailing Address - Phone:808-677-6787
Mailing Address - Fax:808-677-6786
Practice Address - Street 1:91-2139 FT. WEAVER RD.
Practice Address - Street 2:#205
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-3608
Practice Address - Country:US
Practice Address - Phone:808-677-6787
Practice Address - Fax:808-677-6786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD11351208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH36148Medicare UPIN