Provider Demographics
NPI:1871785295
Name:SOWA, RONALD WALTER (MD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:WALTER
Last Name:SOWA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1370 HIAHIA ST
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-9700
Mailing Address - Country:US
Mailing Address - Phone:808-268-0136
Mailing Address - Fax:
Practice Address - Street 1:1370 HIAHIA ST
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-9700
Practice Address - Country:US
Practice Address - Phone:808-268-0136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-10
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider