Individual
DR. EDWIN F ETCUBANEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2100 KANOELEHUA AVE, B9, HILO, HI 96720-6500
(808) 981-1700
(808) 981-1701
Mailing address
2100 KANOELEHUA AVE, B9, HILO, HI 96720-6500
(808) 981-1700
(808) 981-1701
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301045023
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0800900422
BLUE CROSS BLUE SHIELD
MI
01
—
080D410020
COMMUNITY BLUE
MI
01
—
1009100
HEALTH ADVANTAGE NETWORK
MI
01
—
1009110
MCLAREN HEALTH PLAN
MI
05
—
4395680
—
MI
05
—
4433932
—
MI
01
—
540Z90298
HEALTH PLUS
MI
01
—
D72564
HEALTH NET FEDERAL SERVIC
MI
Enumeration date
11/15/2005
Last updated
09/10/2013
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