DR. ROBERT RANDOLPH WATERFORD (NPI# 1376559203) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376559203 |
| Entity Type | Individual |
| Full Name | DR. ROBERT RANDOLPH WATERFORD |
| Credential | MD |
| Practice Address |
385 Hukilike St Suite 210 Kahului HI 96732-3522 |
| Mailing Address |
Po Box 923 Wailuku HI 96793-0923 |
| Practice Telephone | 8088718346 |
| Practice Fax Number | 8088718344 |
| Mailing Telephone | 8082685789 |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2013-02-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
15055 | HI | Allopathic & Osteopathic Physicians |
| N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 15055 | HI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| HI | MEDICARE PTAN | BW115Y | 01 |
| Street Address |
385 HUKILIKE ST SUITE 210 |
| City | KAHULUI |
| State | HI |
| Zip Code | 96732-3522 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134749435 | Catherine Phan | Behavior Technician | 427 Ala Makani St, Suite 200, Kahului, HI 96732 | 2020-04-16 |
| 1427535665 | Miles H. Katahara, D.d.s., Inc. | Dentist | 140 Hoohana St. Suite 204, Kahului, HI 96732 | 2018-07-20 |
| 1013428291 | Maui Family Young Men's Christian Association | Health Educator | 250 Kanaloa Ave, Kahului, HI 96732 | 2017-10-16 |
| 1467998765 | Costco | Clinic/Center | 540 Haleakala Highway, Kahului, HI 96732 | 2017-01-10 |
| 1164884649 | Arc of Maui County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 450a Kanaloa Street, Kahului, HI 96732 | 2016-03-24 |
| 1487016846 | Arc of Maui County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 450 B Kanaloa Avenue, Kahului, HI 96732 | 2016-03-24 |
| 1396118311 | Allison Yoshimoto | Speech-Language Pathologist | 122 Anamuli Street, Kahului, HI 96732 | 2015-11-13 |
| 1609252295 | Nanc Ellen Fellerman (-yahr) | Speech-Language Pathologist | 161 S. Wakea Avenue, Imua Family Services, Kahului, HI 96732 | 2015-08-05 |
| 1134508716 | Bayada Home Care | Community/Behavioral Health | 427 Ala Makani Street, Suite 200, Kahului, HI 96732 | 2015-05-28 |
| 1467843656 | B.c.p., Inc. Dba/ Bayada Home Health Care | Home Health | 427 Ala Makani St., Suite 200, Kahului, HI 96732 | 2015-02-10 |
| Find all providers in zip 96732 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891013199 | Pacific Rim Cardiovascular Inc | Surgery | 385 Hukilike St., Suite 210, Kahului, HI 96732 | 2010-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366880098 | Nathan Koji Itoga | Surgery | 1508 Laukahi St, Honolulu, HI 96821-1432 | 2013-06-04 |
| 1528307006 | Vein Clinics of Hawaii LLC | Surgery | 65-1158 Mamalahoa Hwy Ste 16, Kamuela, HI 96743-8442 | 2013-02-04 |
| 1568781623 | James D. Greig, M.d. Inc. | Surgery | 321 N Kuakini St Ste 814, Honolulu, HI 96817-2362 | 2010-05-27 |
| 1184829558 | David Kin Ming Wong | Surgery | 550 Beretania St. Ste 505, Hawaii Vascular and Endovascular, Inc, Honolulu, HI 96813 | 2007-06-18 |
| 1568541506 | Robert Kistner | Surgery | 848 S Beretania St, Ste 307, Honolulu, HI 96813-2551 | 2006-11-02 |
| 1467531400 | Kistner Vein Clinic | Surgery | 848 S Beretania St Ste 307, Honolulu, HI 96813-2551 | 2006-11-02 |
| 1851323471 | Dean T Sato | Surgery | 550 S Beretania St Ste 505, Honolulu, HI 96813-2496 | 2006-07-06 |
| 1720043706 | James D Greig | Surgery | 321 N Kuakini Street, Suite 814, Honolulu, HI 96817 | 2006-04-20 |
| 1154888014 | Pacific Vascular Associates, LLC | Surgery | 98-1079 Moanalua Rd Ste 620, Aiea, HI 96701-4716 | 2019-02-27 |
| 1245611912 | Cole Nishikawa | Surgery | 98-1079 Moanalua Rd Ste 620, Aiea, HI 96701-4716 | 2015-06-17 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.