Provider Demographics
NPI:1023033743
Name:HARA, KEVIN SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:SCOTT
Last Name:HARA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:98-1079 MOANALUA RD
Mailing Address - Street 2:SUITE 430
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-4713
Mailing Address - Country:US
Mailing Address - Phone:808-484-2000
Mailing Address - Fax:808-488-6580
Practice Address - Street 1:98-1079 MOANALUA RD
Practice Address - Street 2:SUITE 430
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-4713
Practice Address - Country:US
Practice Address - Phone:808-484-2000
Practice Address - Fax:808-488-6580
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HI6581207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI05421801Medicaid
E64700Medicare UPIN
H100716Medicare ID - Type Unspecified