| Ktamura Md Inc | |
|
85 Maui Lani Parkway Wailuku HI 96793-2416 | |
| (530) 241-1473 | |
| (808) 442-5701 |
| Full Name | Ktamura Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 85 Maui Lani Parkway, Wailuku, Hawaii |
| Authorized Official Name and Position | Kristen Tamura (PRESIDENT) |
| Authorized Official Contact | 5302411473 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ktamura Md Inc 85 Maui Lani Parkway Wailuku HI 96793-2416 Ph: (808) 442-5700 | Ktamura Md Inc 85 Maui Lani Parkway Wailuku HI 96793-2416 Ph: (530) 241-1473 |
| NPI Number | 1770136087 |
|---|---|
| Provider Enumeration Date | 07/17/2019 |
| Last Update Date | 11/06/2020 |
| Medicare PECOS PAC ID | 4486088754 |
|---|---|
| Medicare Enrollment ID | O20191218003058 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770136087 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207RN0300X | Internal Medicine - Nephrology | (* (Not Available)) | Primary |
| Provider Name | Kristen P Tamura |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1356502553 PECOS PAC ID: 4385816800 Enrollment ID: I20190402000139 |
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