Provider Demographics
NPI:1639231244
Name:PASQUALE, MICHAEL ANTHONY (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ANTHONY
Last Name:PASQUALE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4224 WAIALAE AVE
Mailing Address - Street 2:PMB153
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-5330
Mailing Address - Country:US
Mailing Address - Phone:808-732-4639
Mailing Address - Fax:808-732-2179
Practice Address - Street 1:500 ALA MOANA BLVD STE 4-470
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-4925
Practice Address - Country:US
Practice Address - Phone:808-945-5433
Practice Address - Fax:808-773-7694
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDOS696208200000X, 2082S0105X, 2086S0122X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Multi-Specialty
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH117028Medicaid
HIF24013Medicare UPIN
HI05393203Medicaid