Provider Demographics
NPI:1194804104
Name:RAYNER, ENID LYNN (MD)
Entity type:Individual
Prefix:DR
First Name:ENID
Middle Name:LYNN
Last Name:RAYNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:888 S KING ST
Mailing Address - Street 2:STRAUB DEPARTMENT OF MEDICINE
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-3009
Mailing Address - Country:US
Mailing Address - Phone:808-522-4512
Mailing Address - Fax:808-522-4513
Practice Address - Street 1:888 S KING ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-3009
Practice Address - Country:US
Practice Address - Phone:808-522-4512
Practice Address - Fax:808-522-4513
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-2535207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI041304 01Medicaid
HI6343444OtherUHA
HI00A0045458OtherHMSA
HIC98601Medicare UPIN
HI6343444OtherUHA