Provider Demographics
NPI:1083059422
Name:CHARKOWSKI, ADRIAN (RD)
Entity Type:Individual
Prefix:
First Name:ADRIAN
Middle Name:
Last Name:CHARKOWSKI
Suffix:
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 HAILI ST
Mailing Address - Street 2:BULDING B
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-2975
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:224 HAILI ST
Practice Address - Street 2:BULDING B
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2975
Practice Address - Country:US
Practice Address - Phone:808-961-4071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-29
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered