Individual
MARK ANTHONY FORTUNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2463 S KIHEI RD # 406, KIHEI, HI 96753-7285
(808) 870-2544
(808) 891-0084
Mailing address
2463 S KIHEI RD # 406, KIHEI, HI 96753-7285
(808) 870-2544
(808) 891-0084
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DOS734
HI
Other
Enumeration date
05/27/2008
Last updated
05/27/2008
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