Basic Information
| Provider Information | |||||||||
| NPI: | 1952332835 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WEINER | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | S. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 468 | ||||||||
| Address2: | |||||||||
| City: | KALAHEO | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967410468 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8086450015 | ||||||||
| FaxNumber: | 8083327837 | ||||||||
| Practice Location | |||||||||
| Address1: | 4489 PAPALINA RD | ||||||||
| Address2: | |||||||||
| City: | KALAHEO | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967418503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8083328523 | ||||||||
| FaxNumber: | 8083327050 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/06/2006 | ||||||||
| LastUpdateDate: | 04/24/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | MD-2925 | HI | Y | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 00A0040574 | 01 | HI | HMSA | OTHER | 99-0262194 | 01 | HI | HMAA | OTHER | 03687101 | 05 | HI | MEDICAID | 0000282897 | 01 | HMSA | OTHER | 036871-05 | 05 | HI | MEDICAID | 03687101 | 01 | HI | ALOHACARE | OTHER | 99-0262194 | 01 | HI | UHA | OTHER | C97658 | 01 | HI | KAISER | OTHER |