Provider Demographics
NPI:1083777932
Name:CHING, DOUGLAS E (MD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:E
Last Name:CHING
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 1:3042 ALANEO PL
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-1504
Mailing Address - Country:US
Mailing Address - Phone:808-280-2790
Mailing Address - Fax:
Practice Address - Street 1:33W KAMEHAMEHA AVE
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-2263
Practice Address - Country:US
Practice Address - Phone:808-868-3253
Practice Address - Fax:808-868-3254
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA71584207X00000X
HIMD-13975207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00A0267466OtherHMSA BILLING NUMBER
HI598873-03Medicaid
CAH91069Medicare UPIN
HI598873-03Medicaid