Provider Demographics
NPI:1164481206
Name:HIRSCH, MARTIN STEWART (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:STEWART
Last Name:HIRSCH
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 1:1650 ALA MOANA BLVD
Mailing Address - Street 2:#1113
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-1432
Mailing Address - Country:US
Mailing Address - Phone:808-947-4038
Mailing Address - Fax:
Practice Address - Street 1:3627 KILAUEA AVE
Practice Address - Street 2:#401
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-2317
Practice Address - Country:US
Practice Address - Phone:808-733-9393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-18
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMDG39992084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI536774Medicaid
HI536774Medicaid