Provider Demographics
NPI:1487766598
Name:ATKINSON, ROBERT EGAN (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:EGAN
Last Name:ATKINSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1380 LUSITANA ST
Mailing Address - Street 2:SUITE 608
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2421
Mailing Address - Country:US
Mailing Address - Phone:808-536-2261
Mailing Address - Fax:808-538-3957
Practice Address - Street 1:1380 LUSITANA ST
Practice Address - Street 2:SUITE 608
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2421
Practice Address - Country:US
Practice Address - Phone:808-536-2261
Practice Address - Fax:808-538-3957
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD4766207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI031001-01Medicaid
HIB98898Medicare UPIN
HI51665Medicare PIN