Provider Demographics
NPI:1023280559
Name:OSTMAN, DOUGLAS CLARK (MD)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:CLARK
Last Name:OSTMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3196 DIAMOND HEAD RD
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-4720
Mailing Address - Country:US
Mailing Address - Phone:808-923-9009
Mailing Address - Fax:
Practice Address - Street 1:3196 DIAMOND HEAD RD
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-4720
Practice Address - Country:US
Practice Address - Phone:808-923-9009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-25
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD 2164207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine