Provider Demographics
NPI:1114113495
Name:KAAWALOA, JEREM NOHEA (MD)
Entity Type:Individual
Prefix:DR
First Name:JEREM
Middle Name:NOHEA
Last Name:KAAWALOA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:868 ULULANI ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-3913
Mailing Address - Country:US
Mailing Address - Phone:808-933-1120
Mailing Address - Fax:808-933-1125
Practice Address - Street 1:868 ULULANI ST
Practice Address - Street 2:SUITE 106
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-3913
Practice Address - Country:US
Practice Address - Phone:808-933-1120
Practice Address - Fax:808-933-1125
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-19
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HI14077207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine