Glenn Michael Wasserman, MD, MPH

Primary specialty

Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X

License

MD-5316 Issued in HI

Practice address

1250 Punchbowl St
Room 423
Honolulu, HI 96813-2416

Phone

(800) 858-6458

NPI assigned

Sep 26, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190764800000",
    "number": "1093902868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47-507 KINANA WAY",
            "city": "KANEOHE",
            "state": "HI",
            "postal_code": "967445414",
            "telephone_number": "808-239-7213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 PUNCHBOWL ST",
            "address_2": "ROOM 423",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132416",
            "telephone_number": "800-858-6458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASSERMAN",
        "first_name": "GLENN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-26",
        "last_updated": "2007-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "HI",
            "license": "MD-5316",
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "HI",
            "license": "MD-5316",
            "primary": true
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "HI",
            "license": "MD-5316",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tabrechai Washington
• Tracy P. Washington, CADAC
• William Washington, MD, MPH, FACPM
• Hiromi Washiyama
• Amanda Wasko, MD
• Amy KG Wassman, PSY.D.
• Scott Dale Wassmer, COTA
• John T. Watabe, MD
• Shawn Watabu
• Travis Watai, M.D.

• Public Health & General Preventive Medicine Physician in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Public Health & General Preventive Medicine Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.