Provider Demographics
NPI:1467745877
Name:CAROLAN, TERENCE JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:TERENCE
Middle Name:JOHN
Last Name:CAROLAN
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 1:2978 HALEKO RD
Mailing Address - Street 2:
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766-1379
Mailing Address - Country:US
Mailing Address - Phone:808-245-8566
Mailing Address - Fax:808-246-4989
Practice Address - Street 1:2978 HALEKO RD
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1379
Practice Address - Country:US
Practice Address - Phone:808-245-8566
Practice Address - Fax:808-246-4989
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-17
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI03145208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics