Doctor Name: | MR. JAMESON JOHN PAWLIK |
NPI Number: | 1174749212 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA-C |
License Number: | PA 1619 |
Business Practice Address: | 41 E Lipoa St Suite 21 Kihei, HI - 967538148 |
Business Phone Number: | 8088750511 |
Business Fax Number: | 8088758595 |
Mailing Address: | 41 E Lipoa St, Suite 21 KIHEI |
State: | HI |
Postal Code: | 967538148 |
Phone Number: | 8088750511 |
Fax Number: | 8088758595 |
NPI Enumeration Date: | 04/17/2007 |
NPI Last Update Date: | 01/10/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | PA 1619 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |