Provider Demographics
NPI:1013914787
Name:DAVID, MARIA THERESA (DO)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:THERESA
Last Name:DAVID
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7 WATERFRONT PL
Mailing Address - Street 2:500 ALA MOANA BLVD., SUITE 300
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-4920
Mailing Address - Country:US
Mailing Address - Phone:808-521-1317
Mailing Address - Fax:808-533-1482
Practice Address - Street 1:3860 WAILEA ALANUI DRIVE,
Practice Address - Street 2:SUITE 102
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753
Practice Address - Country:US
Practice Address - Phone:808-875-1270
Practice Address - Fax:808-875-1281
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HIDOS 679207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00258402Medicaid
HI51393Medicare ID - Type Unspecified
HI00258402Medicaid