| Pradeepta Chowdhury, Md, Llc | |
|
670 Ponahawai St Ste 116 Hilo HI 96720-7831 | |
| (808) 961-3404 | |
| (808) 961-5460 |
| Full Name | Pradeepta Chowdhury, Md, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 670 Ponahawai St, Hilo, Hawaii |
| Authorized Official Name and Position | Pradeepta Chowdhury (OWNER) |
| Authorized Official Contact | 8089613404 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pradeepta Chowdhury, Md, Llc 670 Ponahawai St Ste 116 Hilo HI 96720-7831 Ph: (808) 961-3404 | Pradeepta Chowdhury, Md, Llc 670 Ponahawai St Ste 116 Hilo HI 96720-7831 Ph: (808) 961-3404 |
| NPI Number | 1841305612 |
|---|---|
| Provider Enumeration Date | 08/20/2006 |
| Last Update Date | 02/04/2014 |
| Medicare PECOS PAC ID | 2860499977 |
|---|---|
| Medicare Enrollment ID | O20061102000633 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841305612 | NPI | - | NPPES |
| 00121202 | Medicaid | HI | |
| 10069 | Other | HI | OTHER INSURANCES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 10069 (Hawaii) | Primary |
| Provider Name | Pradeepta Chowdhury |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104864719 PECOS PAC ID: 1052202660 Enrollment ID: I20060830000458 |
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Craig Y. Shikuma, M.d., Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 82 Puuhonu Pl, Suite 207, Hilo, HI 96720 Phone: 808-935-5522 Fax: 808-961-5058 | |
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