Provider Demographics
NPI:1376780650
Name:MATTHES, KAI (MD, PHD)
Entity Type:Individual
Prefix:
First Name:KAI
Middle Name:
Last Name:MATTHES
Suffix:
Gender:M
Credentials:MD, PHD
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 3270
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96801-3270
Mailing Address - Country:US
Mailing Address - Phone:808-538-3232
Mailing Address - Fax:808-538-3220
Practice Address - Street 1:221 MAHALANI ST
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-2526
Practice Address - Country:US
Practice Address - Phone:808-442-5064
Practice Address - Fax:808-442-5067
Is Sole Proprietor?:No
Enumeration Date:2009-01-08
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA225504207LP3000X
HIMD-18269207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology