Provider Demographics
NPI:1386826980
Name:DONN R MARUTANI, MD INC
Entity Type:Organization
Organization Name:DONN R MARUTANI, MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONN
Authorized Official - Middle Name:RYO
Authorized Official - Last Name:MARUTANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-523-6480
Mailing Address - Street 1:321 N KUAKINI ST
Mailing Address - Street 2:#509
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-2364
Mailing Address - Country:US
Mailing Address - Phone:808-523-6480
Mailing Address - Fax:808-599-5961
Practice Address - Street 1:321 N KUAKINI ST
Practice Address - Street 2:#509
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-2364
Practice Address - Country:US
Practice Address - Phone:808-523-6480
Practice Address - Fax:808-599-5961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-05
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD9223207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI07691101Medicaid
HIH54836Medicare PIN
HI07691101Medicaid