# SCOTT J. MISCOVICH MD, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073796868
- **Authorized official:** RENE NOELLE MANSANAS (EXECUTIVE VICE PRESIDENT)
- **Authorized official phone:** (808) 379-1515

## Contact information

- **Practice address:** 46-001 KAMEHAMEHA HWY STE 109, KANEOHE, HI 96744-3724
- **Practice address phone:** (808) 247-7596
- **Mailing address:** 46-001 KAMEHAMEHA HWY STE 109, KANEOHE, HI 96744-3724
- **Mailing address phone:** (808) 247-7596

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | MD6854 | HI | Yes |

## Other

- **Enumeration date:** 12/14/2007
- **Last updated:** 09/06/2024