Ebbert, Larry P

Ebbert, Larry P is an individual health care provider with primary practice located at 85 Maui Lani Pkwy , Wailuku HI 96793-2416. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hematology, Allopathic & Osteopathic Physicians / Medical Oncology, Allopathic & Osteopathic Physicians / Hematology & Oncology. Allopathic & Osteopathic Physicians / Hematology & Oncology is his primary health care specialty. Ebbert, Larry P can be contacted via phone (808) 442-5700.

Contact Information

Primary practice address
85 Maui Lani Pkwy Wailuku HI 96793-2416
Phone: (808) 442-5700
Fax: (808) 442-5652
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology 207RH0000X 2083 South Dakota
Allopathic & Osteopathic Physicians / Medical Oncology 207RX0202X 74117 South Dakota
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X MD-21014 Hawaii

Profile Details

NPI number 1518058163
LBN Legal business name Ebbert, Larry P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 27th, 2006
Last updated May 17th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518058163 NPPES
South Dakota Other 0008428 WELLMARK
South Dakota Other 830007858 WELLMARK
South Dakota Other 2083 WELLMARK
South Dakota MEDICAID 6002482 WELLMARK

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