Individual
KYLE E. MOUERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
910 WAINEE ST, LAHAINA, HI 96761-1622
(808) 662-6900
Mailing address
910 WAINEE ST, LAHAINA, HI 96761-1622
(808) 662-6900
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD-19448
HI
207Q00000X
Family Medicine Physician
MD164064
OR
390200000X
Student in an Organized Health Care Education/Training Program
PG151890
OR
Other
Enumeration date
05/20/2010
Last updated
06/02/2021
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