Provider Demographics
NPI:1083904262
Name:CAROLINA D. DAVIDE, M.D. INC
Entity Type:Organization
Organization Name:CAROLINA D. DAVIDE, M.D. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROLINA
Authorized Official - Middle Name:DOMINICA
Authorized Official - Last Name:DAVIDE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-696-4044
Mailing Address - Street 1:85-910 FARRINGTON HWY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WAIANAE
Mailing Address - State:HI
Mailing Address - Zip Code:96792-2651
Mailing Address - Country:US
Mailing Address - Phone:808-696-4044
Mailing Address - Fax:808-696-4009
Practice Address - Street 1:85-910 FARRINGTON HWY
Practice Address - Street 2:SUITE 102
Practice Address - City:WAIANAE
Practice Address - State:HI
Practice Address - Zip Code:96792-2651
Practice Address - Country:US
Practice Address - Phone:808-696-4044
Practice Address - Fax:808-696-4009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-08
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI12910261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care