Provider Demographics
NPI:1164596904
Name:DOWHAN, DAVID (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:DOWHAN
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 1:415 DAIRY RD
Mailing Address - Street 2:SUITE E-406
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732-2312
Mailing Address - Country:US
Mailing Address - Phone:808-281-8384
Mailing Address - Fax:
Practice Address - Street 1:415 DAIRY RD
Practice Address - Street 2:SUITE E-406
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-2312
Practice Address - Country:US
Practice Address - Phone:808-281-8384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC19062207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC190624Medicaid
AZ197032Medicaid
AZ197032Medicaid
G48187Medicare UPIN