Individual
ALAN O'DONOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
221 MAHALANI ST, WAILUKU, HI 96793-2526
(808) 242-6464
(808) 442-5512
Mailing address
2180 MAIN ST, WAILUKU, HI 96793-1666
(808) 242-6464
(808) 242-4292
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD-11102
HI
208M00000X
Hospitalist Physician
Primary
MD-11102
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
50606603
—
HI
01
—
MD-11102
HI LIC
HI
Enumeration date
06/03/2006
Last updated
03/19/2019
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