Provider Demographics
NPI:1790923878
Name:DONALD K. MARUYAMA, M.D., INC.
Entity Type:Organization
Organization Name:DONALD K. MARUYAMA, M.D., INC.
Other - Org Name:HAWAII ORTHODPAEDIC CLINIC, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:MARUYAMA
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:808-531-0502
Mailing Address - Street 1:321 N. KUAKINI ST.
Mailing Address - Street 2:STE. 814
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-2362
Mailing Address - Country:US
Mailing Address - Phone:808-531-0502
Mailing Address - Fax:808-545-4662
Practice Address - Street 1:321 N. KUAKINI ST.
Practice Address - Street 2:STE. 814
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-2362
Practice Address - Country:US
Practice Address - Phone:808-531-0502
Practice Address - Fax:808-545-4662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-28
Last Update Date:2009-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI951207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
D36187Medicare UPIN
H0000BFCWBMedicare PIN