Andrew Thomas Widholm

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

DOS788 Issued in HI

Practice address

1360 S Beretania St
#215
Honolulu, HI 96814-1520

Phone

(808) 532-3711

Fax

(808) 532-3713

NPI assigned

Jun 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Anesthesia Medical Group Inc

  • Anesthesiology Physician
  • Honolulu, HI
  • NPI 1356362990
  NPD (past)
• Redwood Anesthesia Services, a Medical Corporation

  • Anesthesiology Physician
  • Eureka, CA
  • NPI 1699955252
  NPD (past)

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233187200000",
    "number": "1568408094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 DAIRY RD",
            "address_2": "SUITE E233",
            "city": "KAHULUI",
            "state": "HI",
            "postal_code": "967322348",
            "telephone_number": "808-298-1802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 S BERETANIA ST",
            "address_2": "#215",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141520",
            "telephone_number": "808-532-3711",
            "fax_number": "808-532-3713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDHOLM",
        "first_name": "ANDREW",
        "middle_name": "THOMAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2009-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "HI",
            "license": "DOS788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACS",
            "identifier": "002726-01",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "00A0213387",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS TRICARE",
            "identifier": "A020",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Whole Path Integrative Care Inc
• Wanyu Whye
• Ashley Wiberg, LCSW
• Maxim Wichmann, RBT
• Judith Wicks
• Christina Hotaru Wiedmer, MD
• Andrea Wieland, APRN - RX, FNP -C
• Robin Wielins, AUD
• John Clay Wiggins
• Emma Lee Wigren

• Anesthesiology Physician in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Anesthesiology Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2009; 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.