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Contact Information

BERTRAM C PROVIDENCE, MD
459 PATTERSON RD
HONOLULU, HI96819-1522
 Phone: 808-433-0600
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Adult Reconstructive Orthopaedic Surgery

207XS0114X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for BERTRAM C PROVIDENCE · (Male)

NPI Number 1174512057
Status Active
Credentials MD
Entity Individual
Enumeration date 10/14/2005
Last updated 05/30/2024 - About 2 years ago
Sole proprietor 1 No
Identifiers
  • HI License # MD-11256
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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