Provider Demographics
NPI:1760536759
Name:MCGRATH, MICHAEL J (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:MCGRATH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75-1091 KAMALANI STREET
Mailing Address - Street 2:
Mailing Address - City:HOLUALOA
Mailing Address - State:HI
Mailing Address - Zip Code:96725-1719
Mailing Address - Country:US
Mailing Address - Phone:808-334-4400
Mailing Address - Fax:
Practice Address - Street 1:75-1091 KAMALANI ST
Practice Address - Street 2:
Practice Address - City:HOLUALOA
Practice Address - State:HI
Practice Address - Zip Code:96725-9646
Practice Address - Country:US
Practice Address - Phone:808-334-4400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD - 91722084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000202721OtherHMSA
HI075459-08Medicaid
HI0000202721Medicaid
HI00G0202726OtherHMSA BILLING NUMBER (KAISER)
HI07545902OtherALOHA CARE
HI0000202721Medicaid
HICF287ZMedicare PIN
HIF38118Medicare UPIN