Provider Demographics
NPI:1235211285
Name:HAFERMANN, DAVID RUDOLF (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:RUDOLF
Last Name:HAFERMANN
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:PO BOX 1922
Mailing Address - Street 2:
Mailing Address - City:KAUNAKAKAI
Mailing Address - State:HI
Mailing Address - Zip Code:96748-1922
Mailing Address - Country:US
Mailing Address - Phone:808-553-3573
Mailing Address - Fax:
Practice Address - Street 1:280 HOMEOLU PLACE
Practice Address - Street 2:
Practice Address - City:KAUNAKAKAI
Practice Address - State:HI
Practice Address - Zip Code:96748
Practice Address - Country:US
Practice Address - Phone:808-553-3121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-12390207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease