Provider Demographics
NPI:1194775304
Name:NIMS, MATTHEW JON (MD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:JON
Last Name:NIMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:94-1221 KA UKA BLVD
Mailing Address - Street 2:UNIT#108
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-6202
Mailing Address - Country:US
Mailing Address - Phone:808-295-0419
Mailing Address - Fax:808-627-0315
Practice Address - Street 1:94-1221 KA UKA BLVD
Practice Address - Street 2:UNIT#108
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-6202
Practice Address - Country:US
Practice Address - Phone:808-295-0419
Practice Address - Fax:808-627-0315
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2010-02-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
HIMD-14163207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology