Provider Demographics
NPI:1497325161
Name:FUSION MEDICINE & WELLNESS LLC
Entity Type:Organization
Organization Name:FUSION MEDICINE & WELLNESS LLC
Other - Org Name:FUSION MEDICINE & WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLOTTE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHARFEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-726-2461
Mailing Address - Street 1:PO BOX 811
Mailing Address - Street 2:
Mailing Address - City:KAPAAU
Mailing Address - State:HI
Mailing Address - Zip Code:96755-0811
Mailing Address - Country:US
Mailing Address - Phone:808-726-2461
Mailing Address - Fax:
Practice Address - Street 1:54-3858 AKONI PULE HWY
Practice Address - Street 2:
Practice Address - City:KAPA'AU
Practice Address - State:HI
Practice Address - Zip Code:96755-9675
Practice Address - Country:US
Practice Address - Phone:808-726-2461
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-25
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty