Individual
ELIOT A. DEMELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4643 WAIMEA CANYON RD, WAIMEA, HI 96796
(904) 805-1300
(904) 805-1302
Mailing address
PO BOX 869, WAIANAE, HI 96792-0869
(904) 805-1300
(904) 805-1302
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD-4005
HI
207P00000X
Emergency Medicine Physician
MD4005
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00298003
—
HI
05
—
00298009
—
HI
01
—
56214644596746A011
TRICARE
HI
01
—
56214644596796A020
TRICARE
HI
Enumeration date
06/22/2006
Last updated
07/02/2015
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