Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. BERTRAM CLIFFORD PROVIDENCE, M.D.
ActiveDR. BERTRAM CLIFFORD PROVIDENCE, M.D. is a Sports Medicine (Orthopaedic) healthcare provider located in HONOLULU, Hawaii. NPI 1174512057 is currently active in the NPPES registry. Verify at CMS.
Sports Medicine (Orthopaedic) · HONOLULU, HI
Registration Details
- NPI Number
- 1174512057
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 14, 2005 (20.87961588743 yrs)
- Last Updated
- May 30, 2024
- License
-
MD-11256 (HI)
Practice Information
- Address
-
459 PATTERSON RDHONOLULU, HI, 968191522Browse HI providers · Browse ZIP 96819
- Phone
- 8084330600
- Primary Specialty
-
Sports Medicine (Orthopaedic)
207XS0114X
Other Sports Medicine (Orthopaedic) Providers in HONOLULU, HI
| Name | Credential | NPI |
|---|---|---|
| DR. GREGORY Y. LEE | — | 1528139276 |
| DR. TIARE E SALASSA | M.D. | 1487897930 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.