Dr. Russell M Tom Llc | |
98-1079 Moanalua Rd Ste 350 Aiea HI 96701-4714 | |
(808) 487-2277 | |
(808) 488-5582 |
Full Name | Dr. Russell M Tom Llc |
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Speciality | Internal Medicine |
Location | 98-1079 Moanalua Rd Ste 350, Aiea, Hawaii |
Authorized Official Name and Position | Hien Ramones (BILLER) |
Authorized Official Contact | 8086297845 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Dr. Russell M Tom Llc 98-1079 Moanalua Rd Ste 350 Aiea HI 96701-4714 Ph: (808) 487-2277 | Dr. Russell M Tom Llc 98-1079 Moanalua Rd Ste 350 Aiea HI 96701-4714 Ph: (808) 487-2277 |
NPI Number | 1659091171 |
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Provider Enumeration Date | 09/02/2022 |
Last Update Date | 09/02/2022 |
Medicare PECOS PAC ID | 0143690628 |
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Medicare Enrollment ID | O20221227000876 |
Identifier | Type | State | Issuer |
---|---|---|---|
1659091171 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Russell M Tom |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1346258407 PECOS PAC ID: 2769373547 Enrollment ID: I20101214000905 |
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