Provider Demographics
NPI:1679527691
Name:HANING, WILLIAM FREES III (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:FREES
Last Name:HANING
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1356 LUSITANA ST
Mailing Address - Street 2:4TH FLOOR, DEPARTMENT OF PSYCHIATRY
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2421
Mailing Address - Country:US
Mailing Address - Phone:808-586-7436
Mailing Address - Fax:808-586-2940
Practice Address - Street 1:1356 LUSITANA ST
Practice Address - Street 2:4TH FLOOR, DEPARTMENT OF PSYCHIATRY
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2421
Practice Address - Country:US
Practice Address - Phone:808-586-7436
Practice Address - Fax:808-586-2940
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-22
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD3042174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GU042206-02Medicaid
GU042206-02Medicaid
HID43564Medicare UPIN