Provider Demographics
NPI:1205892072
Name:GIORDANO, CARRIE MAY (DO)
Entity type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:MAY
Last Name:GIORDANO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 WAILEA GATEWAY PLACE A203
Mailing Address - Street 2:
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753
Mailing Address - Country:US
Mailing Address - Phone:808-879-1859
Mailing Address - Fax:808-879-1838
Practice Address - Street 1:34 WAILEA GATEWAY PL # A203
Practice Address - Street 2:
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-6525
Practice Address - Country:US
Practice Address - Phone:808-879-1859
Practice Address - Fax:808-879-1838
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-113862207V00000X
HIDOS-1843207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1621149OtherBLUE SHIELD PROVIDER ID
IL1621149OtherBLUE SHIELD PROVIDER ID
ILI35105Medicare UPIN