Provider Demographics
NPI:1881989754
Name:VIERKOETTER, KOAH ROBIN (MD)
Entity type:Individual
Prefix:
First Name:KOAH
Middle Name:ROBIN
Last Name:VIERKOETTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:737 BISHOP ST STE 2060
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-3214
Mailing Address - Country:US
Mailing Address - Phone:808-691-4271
Mailing Address - Fax:808-691-4045
Practice Address - Street 1:1301 PUNCHBOWL ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2402
Practice Address - Country:US
Practice Address - Phone:808-538-2702
Practice Address - Fax:808-533-4008
Is Sole Proprietor?:No
Enumeration Date:2011-06-18
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-19053207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology