Provider Demographics
NPI:1356565774
Name:THAL, ALAN DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:DAVID
Last Name:THAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 879
Mailing Address - Street 2:
Mailing Address - City:KAPAAU
Mailing Address - State:HI
Mailing Address - Zip Code:96755-0879
Mailing Address - Country:US
Mailing Address - Phone:808-889-5556
Mailing Address - Fax:808-889-5411
Practice Address - Street 1:55-3327 AKONI PULE HIGHWAY
Practice Address - Street 2:
Practice Address - City:HAWI
Practice Address - State:HI
Practice Address - Zip Code:96719
Practice Address - Country:US
Practice Address - Phone:808-889-5556
Practice Address - Fax:808-889-5411
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HIMD5213207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine