Provider Demographics
NPI:1033286281
Name:RAELSON, JAMES F (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:F
Last Name:RAELSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 929
Mailing Address - Street 2:
Mailing Address - City:KALAHEO
Mailing Address - State:HI
Mailing Address - Zip Code:96741-0929
Mailing Address - Country:US
Mailing Address - Phone:808-353-3953
Mailing Address - Fax:808-353-3941
Practice Address - Street 1:2469 PUU RD STE C
Practice Address - Street 2:
Practice Address - City:KALAHEO
Practice Address - State:HI
Practice Address - Zip Code:96741-8509
Practice Address - Country:US
Practice Address - Phone:808-353-3953
Practice Address - Fax:808-353-3941
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-13598208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
0000257097OtherHMSA
MD13598OtherMDX
57943500OtherQUEST ALOHACARE
6653402OtherUHA
H58169OtherKAISER
0000257097OtherBCBS
0000257097OtherTRICARE
0000257097OtherQUEST HMSA
99-0262194OtherHMAA
0000257097OtherBCBS