NPI 1104544501 · live from the CMS NPI Registry
Mark Gripp
Radiology, Diagnostic Radiology in Honolulu, HI. National Provider Identifier 1104544501, active.
NPI record
| NPI | 1104544501 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Radiology, Diagnostic Radiology 2085R0202X |
| Practice location | 711 Kapiolani Blvd Ste 200, Honolulu, HI 96813 |
| Practice phone | 403-594-1883 |
| Mailing address | 46-157 Nahiku Pl, Kaneohe, HI 96744 |
| Enumerated | August 22, 2022 |
| Last updated | August 22, 2022 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Radiology, Diagnostic Radiology primary | 2085R0202X | MED-PHYS-LIC-114091 (MT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.