Provider Demographics
NPI:1306931886
Name:DE BUEGER, MARTIN F (PT)
Entity type:Individual
Prefix:
First Name:MARTIN
Middle Name:F
Last Name:DE BUEGER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1337 HIGHVIEW PLACE
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816
Mailing Address - Country:US
Mailing Address - Phone:808-735-8416
Mailing Address - Fax:
Practice Address - Street 1:6650 HAWAII KAI DR
Practice Address - Street 2:SUITE 101
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96825-1100
Practice Address - Country:US
Practice Address - Phone:808-396-8908
Practice Address - Fax:808-396-8909
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT2162225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00B0243515OtherTRICARE KAI
HI57146503Medicaid
HI6476318OtherUHA 99-0332020
HI00A0243517OtherHNL HMSA PPO/HMO/QST/65C
HIP00315095OtherMEDICARE RAILROAD
HI57146500OtherALOHA CARE
HI57146502Medicaid
00G0243514OtherHMSA MEDICARE HKRH
HI00A0243517OtherTRICARE HNL
HI00B0243515OtherKAI HMSA PPO/HMO/QST/65C
HI505170OtherHMA
HI99-0332020OtherHMAA
HI00F0243516OtherHMSA MEDICARE @ HK DR
HI204196700OtherOWCP
HI99-0332020OtherHMAA