Individual
ADIVITCH SRIPUSANAPAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1356 LUSITANA ST FL 7, HONOLULU, HI 96813-2409
(808) 691-4970
Mailing address
1356 LUSITANA ST FL 7, HONOLULU, HI 96813-2409
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MDR
HI
Other
Enumeration date
04/15/2025
Last updated
04/15/2025
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