Stefanie Park Md Llc | |
347 N Kuakini St Honolulu HI 96817-2336 | |
(808) 536-0300 | |
(808) 536-0320 |
Full Name | Stefanie Park Md Llc |
---|---|
Speciality | Internal Medicine |
Location | 347 N Kuakini St, Honolulu, Hawaii |
Authorized Official Name and Position | Stefanie M Park (OWNER) |
Authorized Official Contact | 8087531686 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Stefanie Park Md Llc Po Box 25490 Honolulu HI 96825-0490 Ph: (808) 536-0314 | Stefanie Park Md Llc 347 N Kuakini St Honolulu HI 96817-2336 Ph: (808) 536-0300 |
NPI Number | 1598984403 |
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Provider Enumeration Date | 04/25/2007 |
Last Update Date | 10/11/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1598984403 | NPI | - | NPPES |
594300 | Medicaid | HI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 14109 (Hawaii) | Primary |
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