Boardsportsdoc | |
68-615 Farrington Hwy 21a Waialua HI 96791-9377 | |
(303) 882-7739 | |
Not Available |
Full Name | Boardsportsdoc |
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Speciality | Internal Medicine - Sports Medicine |
Location | 68-615 Farrington Hwy, Waialua, Hawaii |
Authorized Official Name and Position | Clayton Austin Everline (PHYSICIAN) |
Authorized Official Contact | 3038827739 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Boardsportsdoc 68-615 Farrington Hwy 21a Waialua HI 96791-9377 Ph: (303) 882-7739 | Boardsportsdoc 68-615 Farrington Hwy 21a Waialua HI 96791-9377 Ph: (303) 882-7739 |
NPI Number | 1871819318 |
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Provider Enumeration Date | 04/08/2010 |
Last Update Date | 12/22/2011 |
Identifier | Type | State | Issuer |
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1871819318 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RS0010X | Internal Medicine - Sports Medicine | MD-15206 (Hawaii) | Primary |