Provider Demographics
NPI:1083762918
Name:DICK, JOHN SOMERS BUIST II (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:SOMERS BUIST
Last Name:DICK
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1300
Mailing Address - Street 2:MAILCODE 61325
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96807-1300
Mailing Address - Country:US
Mailing Address - Phone:808-955-0255
Mailing Address - Fax:808-955-4155
Practice Address - Street 1:23 PAA ST
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-3606
Practice Address - Country:US
Practice Address - Phone:808-877-8955
Practice Address - Fax:808-877-8957
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HIMD6264207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology