Provider Demographics
NPI:1831207448
Name:SPIELMAN, STUART HENRY (MD)
Entity type:Individual
Prefix:
First Name:STUART
Middle Name:HENRY
Last Name:SPIELMAN
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:PO BOX 479
Mailing Address - Street 2:
Mailing Address - City:WAIMEA
Mailing Address - State:HI
Mailing Address - Zip Code:96796-0479
Mailing Address - Country:US
Mailing Address - Phone:808-332-5414
Mailing Address - Fax:
Practice Address - Street 1:2180 MAIN ST
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-1666
Practice Address - Country:US
Practice Address - Phone:808-242-6464
Practice Address - Fax:808-242-4292
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD 29162085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI036750-01Medicaid
HIMD2916-02OtherMDX
HIMD-2916OtherMD LICENSE
HIH102104Medicare PIN
HI036750-01Medicaid