Provider Demographics
NPI:1750430799
Name:SAVONA, MICHAEL RICHARD (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:RICHARD
Last Name:SAVONA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1830 WELLS ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-2365
Mailing Address - Country:US
Mailing Address - Phone:808-242-5599
Mailing Address - Fax:808-242-2838
Practice Address - Street 1:1830 WELLS ST
Practice Address - Street 2:SUITE 102
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-2365
Practice Address - Country:US
Practice Address - Phone:808-242-5599
Practice Address - Fax:808-242-2838
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
HI2890207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH0000BDNCBMedicare ID - Type Unspecified
HIC90868Medicare UPIN