DR. BERTRAM CLIFFORD PROVIDENCE M.D.
NPI 1174512057
Orthopaedic Surgery - Adult Reconstructive Orthopaedic Surgery in Honolulu, HI

Q: What is Bertram Providence's NPI number?

The NPI number for Bertram Providence is 1174512057. It was assigned to this individual provider in the NPPES registry on October 14, 2005.

Q: What is Bertram Providence's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Adult Reconstructive Orthopaedic Surgery, with taxonomy code 207XS0114X.

Active since October 14, 2005

459 PATTERSON RD, HONOLULU, HI 96819(808) 433-0600 Get Directions Write a Review

NPPES record last updated: May 30, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Bertram Clifford Providence M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. BERTRAM CLIFFORD PROVIDENCE M.D. (NPI 1174512057) is an individual adult reconstructive orthopaedic surgery provider in Honolulu, Hawaii, licensed in Hawaii (MD-11256) and active in the NPI registry since October 2005. He maintains a secondary practice location in Tamc.

NPPES Registry Identity

NPI1174512057

Entity TypeIndividualMale

Primary Taxonomy207XS0114X

Provider Legal NameDR. BERTRAM CLIFFORD PROVIDENCECredential: M.D.

Location Address459 PATTERSON RDHonolulu, HI 96819-1522

Mailing Address459 Patterson RdHonolulu, HI 96819-1522 · (808) 433-0600

Phone(808) 433-0600

Sole ProprietorNo

Enumeration DateOctober 14, 2005

Last NPPES UpdateMay 30, 2024

NPPES CertifiedMay 22, 2024

✔ NPI 1174512057 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic Surgery · Adult Reconstructive Orthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207XS0114X

License✔ Licensed in HI · MD-11256

Definition

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.

459 PATTERSON RD, Honolulu, HI 96819

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Secondary Practice Location 1

Location 11 Jarrett White RoadTAMC, HI 96819 · Phone (808) 433-5551

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. DEAN S KUMASAKA

Pharmacist