Waterford, Robert Randolph

Waterford, Robert Randolph is an individual health care provider with primary practice located at 385 Hukilike St Suite 210, Kahului HI 96732-3522. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), Allopathic & Osteopathic Physicians / Vascular Surgery. Allopathic & Osteopathic Physicians / Vascular Surgery is his primary health care specialty. Waterford, Robert Randolph can be contacted via phone (808) 871-8346.

Contact Information

Primary practice address
385 Hukilike St Suite 210 Kahului HI 96732-3522
Phone: (808) 871-8346
Fax: (808) 871-8344
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 15055 Hawaii
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 15055 Hawaii

Profile Details

NPI number 1376559203
LBN Legal business name Waterford, Robert Randolph
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 31st, 2006
Last updated Feb 15th, 2013 - about 12 years ago

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 1376559203 NPPES
Hawaii Other BW115Y MEDICARE PTAN

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