Provider Demographics
NPI:1649560517
Name:KNOWLES, DAVID A (PA-C)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:A
Last Name:KNOWLES
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 1:67-1185 MAMALAHOA HWY
Mailing Address - Street 2:
Mailing Address - City:KAMUELA
Mailing Address - State:HI
Mailing Address - Zip Code:96743-7304
Mailing Address - Country:US
Mailing Address - Phone:808-881-4500
Mailing Address - Fax:
Practice Address - Street 1:67-1185 MAMALAHOA HWY
Practice Address - Street 2:
Practice Address - City:KAMUELA
Practice Address - State:HI
Practice Address - Zip Code:96743-7304
Practice Address - Country:US
Practice Address - Phone:808-881-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-13
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
HIAMD-424363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant