| Scott J. Miscovich Md, Llc | |
|
46-001 Kamehameha Hwy Ste 109 Kaneohe HI 96744-3724 | |
| (808) 247-7596 | |
| Not Available |
| Full Name | Scott J. Miscovich Md, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 46-001 Kamehameha Hwy Ste 109, Kaneohe, Hawaii |
| Authorized Official Name and Position | Rene Noelle Mansanas (EXECUTIVE VICE PRESIDENT) |
| Authorized Official Contact | 8083791515 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Scott J. Miscovich Md, Llc 46-001 Kamehameha Hwy Ste 109 Kaneohe HI 96744-3724 Ph: (808) 247-7596 | Scott J. Miscovich Md, Llc 46-001 Kamehameha Hwy Ste 109 Kaneohe HI 96744-3724 Ph: (808) 247-7596 |
| NPI Number | 1073796868 |
|---|---|
| Provider Enumeration Date | 12/14/2007 |
| Last Update Date | 09/06/2024 |
| Medicare PECOS PAC ID | 2961391537 |
|---|---|
| Medicare Enrollment ID | O20040311001394 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073796868 | NPI | - | NPPES |
| 05672605 | Medicaid | HI | |
| T065197 | Other | HI | HMSA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD6854 (Hawaii) | Primary |
| Provider Name | Scott John Miscovich |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669529400 PECOS PAC ID: 9931098506 Enrollment ID: I20100924000505 |
| Provider Name | Elizabeth Stoltzman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437514643 PECOS PAC ID: 0446533178 Enrollment ID: I20170203000668 |
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