Provider Demographics
NPI:1427103647
Name:NIP, VINCENT J (MD)
Entity type:Individual
Prefix:
First Name:VINCENT
Middle Name:J
Last Name:NIP
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1380 LUSITANA ST
Mailing Address - Street 2:STE 808
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813
Mailing Address - Country:US
Mailing Address - Phone:808-538-1050
Mailing Address - Fax:808-538-0108
Practice Address - Street 1:1380 LUSITANA ST
Practice Address - Street 2:STE 808
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813
Practice Address - Country:US
Practice Address - Phone:808-538-1050
Practice Address - Fax:808-538-0108
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
HI55962082S0099X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2082S0099XAllopathic & Osteopathic PhysiciansPlastic SurgeryPlastic Surgery Within the Head and Neck
Not Answered2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI07024501Medicaid
HI0091280OtherHMSA
HI0091280OtherHMSA
F00803Medicare UPIN