Provider Demographics
NPI:1386849438
Name:WACHI, KELLY MARI (MD)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:MARI
Last Name:WACHI
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Gender:F
Credentials:MD
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Mailing Address - Street 1:65-1230 MAMALAHOA HWY
Mailing Address - Street 2:SUITE C21
Mailing Address - City:KAMUELA
Mailing Address - State:HI
Mailing Address - Zip Code:96743-8318
Mailing Address - Country:US
Mailing Address - Phone:808-887-0033
Mailing Address - Fax:808-887-0035
Practice Address - Street 1:65-1230 MAMALAHOA HWY
Practice Address - Street 2:SUITE C21
Practice Address - City:KAMUELA
Practice Address - State:HI
Practice Address - Zip Code:96743-8318
Practice Address - Country:US
Practice Address - Phone:808-887-0033
Practice Address - Fax:808-887-0035
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-19
Last Update Date:2009-10-27
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Provider Licenses
StateLicense IDTaxonomies
HIMD-13891207R00000X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine