Provider Demographics
NPI:1679997191
Name:GARVEY, CHERYLIN (MD)
Entity Type:Individual
Prefix:
First Name:CHERYLIN
Middle Name:
Last Name:GARVEY
Suffix:
Gender:F
Credentials:MD
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 550
Mailing Address - Street 2:
Mailing Address - City:KAMUELA
Mailing Address - State:HI
Mailing Address - Zip Code:96743-0550
Mailing Address - Country:US
Mailing Address - Phone:808-885-3211
Mailing Address - Fax:
Practice Address - Street 1:64-5255 IOKUA PLACE
Practice Address - Street 2:
Practice Address - City:KAMUELA
Practice Address - State:HI
Practice Address - Zip Code:96743-0550
Practice Address - Country:US
Practice Address - Phone:808-885-3211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-05
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD4250208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics