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Individual

EVELYN MACINTYRE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2180 MAIN ST, WAILUKU, HI 96793-1666
(808) 242-6464
(808) 984-7434
Mailing address
2180 MAIN ST, WAILUKU, HI 96793-1666
(808) 242-6464
(808) 984-7434

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD11809
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
139543
UHA
HI
01
233643
HMSA - 65CP - HMSA QUEST
HI
01
99017685996793B099
TRICARE - CHAMPUS
HI
Enumeration date
07/22/2006
Last updated
04/08/2008
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