Provider Demographics
NPI:1053433441
Name:DUERLER, TIMOTHY S (MD)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:S
Last Name:DUERLER
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 1:64-1032 MAMALAHOA HWY 306
Mailing Address - Street 2:
Mailing Address - City:KAMUELA
Mailing Address - State:HI
Mailing Address - Zip Code:96743-8441
Mailing Address - Country:US
Mailing Address - Phone:808-769-5010
Mailing Address - Fax:808-769-5208
Practice Address - Street 1:75 PUUHONU PL
Practice Address - Street 2:STE 205
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2000
Practice Address - Country:US
Practice Address - Phone:808-933-2399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT144979207Q00000X
HI14081207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine