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Individual

HEATHER HAYNES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
95 MAHALANI ST, RM 21, WAILUKU, HI 96793
(808) 244-4647
(808) 242-6676
Mailing address
95 MAHALANI ST, RM 21, WAILUKU, HI 96793
(808) 442-6856
(808) 242-6676

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD10642
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
252152
HI
05
25215201
HI
Enumeration date
08/09/2006
Last updated
10/08/2015
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