Provider Demographics
NPI:1558344622
Name:HAMLIN, ELVIN RAY (DO)
Entity Type:Individual
Prefix:
First Name:ELVIN
Middle Name:RAY
Last Name:HAMLIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 PUUHONU PL STE 108
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-2060
Mailing Address - Country:US
Mailing Address - Phone:808-934-2009
Mailing Address - Fax:808-934-2041
Practice Address - Street 1:670 PONAHAWAI ST STE 220
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2660
Practice Address - Country:US
Practice Address - Phone:808-935-7747
Practice Address - Fax:808-935-7752
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO311632084N0400X
HIDOS-11002084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI595431-01Medicaid
HI0000267005OtherBCBS HAWAII HMSA
HIH102687Medicare PIN
HI595431-01Medicaid