DR. BERTRAM CLIFFORD PROVIDENCE M.D. NPI 1174512057

NPI Information

  • NPI: 1174512057
  • Provider Name: DR. BERTRAM CLIFFORD PROVIDENCE, M.D.
  • Classification: Orthopaedic Surgery - 207XS0114X
  • Specialization: Adult Reconstructive Orthopaedic Surgery
  • Entity Type: Individual
  • Address: 459 PATTERSON RD
    HONOLULU, HI
    ZIP 96819
  • Phone: (808) 433-0600

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NPI Details

DR. Bertram Clifford Providence, M.D. is an adult reconstructive orthopaedic surgery orthopaedic surgery in Honolulu, HI. The provider is recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, adult reconstructive orthopaedic surgeons deal with reconstructive procedures such as joint arthroplasty (i.e., hip and knee), osteotomy, arthroscopy, soft-tissue reconstruction, and a variety of other adult reconstructive surgical procedures. DR. Bertram Clifford Providence, M.D. NPI is 1174512057. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

459 PATTERSON RD
HONOLULU, HI
ZIP 96819-522
Phone: (808) 433-0600

The enumeration date for this NPI number is 10/14/2005 and was last updated on 5/30/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207XS0114XOrthopaedic SurgeryAdult Reconstructive Orthopaedic SurgeryMD-11256HAWAIIYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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