Provider Demographics
NPI:1851553556
Name:WILHELM, KATHERINE CHRISTINE (MD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:CHRISTINE
Last Name:WILHELM
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 1:450 KILAUEA AVE
Mailing Address - Street 2:STE 105
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-3089
Mailing Address - Country:US
Mailing Address - Phone:808-961-4071
Mailing Address - Fax:808-961-5678
Practice Address - Street 1:15-2866 PAHOA VILLAGE RD
Practice Address - Street 2:BLDG C
Practice Address - City:PAHOA
Practice Address - State:HI
Practice Address - Zip Code:96778-7720
Practice Address - Country:US
Practice Address - Phone:808-965-9711
Practice Address - Fax:808-965-6240
Is Sole Proprietor?:No
Enumeration Date:2008-06-25
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA118710207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFQ184ZMedicare Oscar/Certification