Doctor Name: | DR. MARK SILVIO PEDRI |
NPI Number: | 1417203126 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.O. M.P.H. |
License Number: | OP 60428780 |
Business Practice Address: | 107 Ala Malama St Kaunakakai, HI - 96748 |
Business Phone Number: | 8085535353 |
Business Fax Number: | 8085534269 |
Mailing Address: | 107 Ala Malama St, KAUNAKAKAI |
State: | HI |
Postal Code: | 96748 |
Phone Number: | 8085535353 |
Fax Number: | 8085534269 |
NPI Enumeration Date: | 07/31/2012 |
NPI Last Update Date: | 04/14/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | OP 60428780 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |