Provider Demographics
NPI:1841281599
Name:MABUTAS, JHOANNA D (MD)
Entity type:Individual
Prefix:DR
First Name:JHOANNA
Middle Name:D
Last Name:MABUTAS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3938 MONTEREY PL
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-3922
Mailing Address - Country:US
Mailing Address - Phone:808-734-6167
Mailing Address - Fax:
Practice Address - Street 1:2239 N SCHOOL ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-2539
Practice Address - Country:US
Practice Address - Phone:808-791-9410
Practice Address - Fax:808-847-6051
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HIMD 12226207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH91124Medicare UPIN