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4366 Kukui Grove St Ste 202 Lihue HI 96766-2006 | |
| (808) 246-3800 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 4366 Kukui Grove St Ste 202, Lihue, Hawaii |
| Authorized Official Name and Position | Henry Brodett (GENERAL MANAGER) |
| Authorized Official Contact | 8082843740 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 89226 Honolulu HI 96830-7226 Ph: (808) 246-3800 | 4366 Kukui Grove St Ste 202 Lihue HI 96766-2006 Ph: (808) 246-3800 |
| NPI Number | 1811392160 |
|---|---|
| Provider Enumeration Date | 10/29/2014 |
| Last Update Date | 10/29/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811392160 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (Hawaii) | Primary |
| 208D00000X | General Practice | (Hawaii) | Secondary |
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