Provider Demographics
NPI:1760455562
Name:INOUYE BAUM, COLLEEN (MD)
Entity Type:Individual
Prefix:DR
First Name:COLLEEN
Middle Name:
Last Name:INOUYE BAUM
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 1:200 KALEPA PL
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732-2471
Mailing Address - Country:US
Mailing Address - Phone:808-871-7122
Mailing Address - Fax:808-877-4134
Practice Address - Street 1:200 KALEPA PL
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-2471
Practice Address - Country:US
Practice Address - Phone:808-871-7122
Practice Address - Fax:808-877-4134
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-5261207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI010707-01OtherALOHACARE
HI00C0020184OtherHMSA QUEST
HI01878701Medicaid
HI00C0020184OtherHMSA
HI01878701Medicaid
HI010707-01OtherALOHACARE
HI00C0020184OtherHMSA