Basic Information
| Provider Information | |||||||||
| NPI: | 1033463948 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | EDMONDS | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | PETER | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 75-5751 KUAKINI HWY | ||||||||
| Address2: | SUITE 203 | ||||||||
| City: | KAILUA KONA | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967401752 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8083263878 | ||||||||
| FaxNumber: | 8083299370 | ||||||||
| Practice Location | |||||||||
| Address1: | 75-5751 KUAKINI HWY | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | KAILUA KONA | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967401752 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8083263878 | ||||||||
| FaxNumber: | 8083299370 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/30/2012 | ||||||||
| LastUpdateDate: | 11/12/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD16784 | HI | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.