Individual
MARK ETTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
221 MAHALANI ST, WAILUKU, HI 96793
(808) 244-9056
Mailing address
151 E WAKEA AVE STE 202, KAHULUI, HI 96732-2475
(434) 962-3607
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
19750
HI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/05/2014
Last updated
08/07/2018
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