Individual
TIGIST NIGATU MAMMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1881 NANI ST, WAILUKU, HI 96793-1811
(808) 871-7772
Mailing address
1881 NANI ST, WAILUKU, HI 96793-1811
(808) 871-7772
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101250000
VA
207R00000X
Internal Medicine Physician
Primary
MD-16389
HI
208000000X
Pediatrics Physician
0101250000
VA
Other
Enumeration date
07/03/2007
Last updated
12/03/2021
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