Provider Demographics
NPI:1851369565
Name:WILLIAMS, ELAINE MARIE (DO)
Entity Type:Individual
Prefix:DR
First Name:ELAINE
Middle Name:MARIE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:105 MAUILANI PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-2443
Mailing Address - Country:US
Mailing Address - Phone:808-244-9555
Mailing Address - Fax:808-244-9577
Practice Address - Street 1:105 MAUILANI PKWY STE 100
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-2443
Practice Address - Country:US
Practice Address - Phone:808-244-9555
Practice Address - Fax:808-244-9577
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-09
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMA-1332-05207RN0300X
HI1208207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMD24533Medicare UPIN
NM34352100Medicare ID - Type Unspecified