| Duke E. Wagner,ph.d.,inc. | |
|
970 N Kalaheo Ave A204 Kailua HI 96734-1801 | |
| (808) 254-5468 | |
| (808) 262-4437 |
| Full Name | Duke E. Wagner,ph.d.,inc. |
|---|---|
| Speciality | Psychologist |
| Location | 970 N Kalaheo Ave, Kailua, Hawaii |
| Authorized Official Name and Position | Duke Elvin Wagner (PRESIDENT) |
| Authorized Official Contact | 8082545468 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Duke E. Wagner,ph.d.,inc. Po Box 2192 Pearl City HI 96782-9192 Ph: (808) 254-5468 | Duke E. Wagner,ph.d.,inc. 970 N Kalaheo Ave A204 Kailua HI 96734-1801 Ph: (808) 254-5468 |
| NPI Number | 1356555791 |
|---|---|
| Provider Enumeration Date | 05/09/2007 |
| Last Update Date | 06/09/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356555791 | NPI | - | NPPES |
| 0000003889 | Other | HI | HMSA |
| 00461901 | Medicaid | HI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PSY298 (Hawaii) | Primary |
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