Provider Demographics
NPI:1861454712
Name:REPKING, DAVID TERRANCE (IDC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:TERRANCE
Last Name:REPKING
Suffix:
Gender:M
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 CHUNG-HOON PL
Mailing Address - Street 2:102
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96818-7367
Mailing Address - Country:US
Mailing Address - Phone:808-473-1014
Mailing Address - Fax:808-473-3109
Practice Address - Street 1:822 CLARK ST
Practice Address - Street 2:USS HONOLULU SSN718 SUITE 400
Practice Address - City:PEARL HARBOR
Practice Address - State:HI
Practice Address - Zip Code:96860-4652
Practice Address - Country:US
Practice Address - Phone:808-474-1128
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other