Provider Demographics
NPI:1649385063
Name:CERKAS, STEPHEN LOUIS (PA -C)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:LOUIS
Last Name:CERKAS
Suffix:
Gender:M
Credentials:PA -C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 94
Mailing Address - Street 2:94 6614 KUAMOO STREET
Mailing Address - City:NAALEHU
Mailing Address - State:HI
Mailing Address - Zip Code:96772-0094
Mailing Address - Country:US
Mailing Address - Phone:808-929-8349
Mailing Address - Fax:
Practice Address - Street 1:219 B KAALAIKI ROAD
Practice Address - Street 2:
Practice Address - City:NAALEHU
Practice Address - State:HI
Practice Address - Zip Code:96772-0590
Practice Address - Country:US
Practice Address - Phone:808-929-7331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAMD 129363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant