Provider Demographics
NPI:1700811718
Name:NIKAITANI, DONALD K (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:K
Last Name:NIKAITANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:75-137 HUALALAI ROAD
Mailing Address - Street 2:KONA-KOHALA HEALTH CARE SERVICES INC.
Mailing Address - City:KAILUA-KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740
Mailing Address - Country:US
Mailing Address - Phone:808-329-1346
Mailing Address - Fax:808-329-1468
Practice Address - Street 1:75-137 HUALALAI ROAD
Practice Address - Street 2:KONA-KOHALA HEALTH CARE SERVICES INC.
Practice Address - City:KAILUA-KONA
Practice Address - State:HI
Practice Address - Zip Code:96740
Practice Address - Country:US
Practice Address - Phone:808-329-1346
Practice Address - Fax:808-329-1468
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HIMD-3709207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI04737601Medicaid
C97545Medicare UPIN
HI04737601Medicaid