Provider Demographics
NPI:1740330885
Name:TAMPLIN, MAURA MICHELE D (PT)
Entity type:Individual
Prefix:MISS
First Name:MAURA MICHELE
Middle Name:D
Last Name:TAMPLIN
Suffix:
Gender:F
Credentials:PT
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 3046
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96733-3046
Mailing Address - Country:US
Mailing Address - Phone:808-280-0229
Mailing Address - Fax:808-242-4100
Practice Address - Street 1:84 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-1725
Practice Address - Country:US
Practice Address - Phone:808-280-0229
Practice Address - Fax:808-242-4100
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT 2514225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0 025658-6OtherHMSA
HI57488101Medicaid
HIH101433Medicare PIN
HIH101432Medicare ID - Type Unspecified