Individual
ANNABELLE MATEO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2180 MAIN ST, WAILUKU, HI 96793-1666
(808) 242-6464
(808) 243-2385
Mailing address
2180 MAIN ST, WAILUKU, HI 96793-1666
(808) 242-6464
(808) 243-2385
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD10493
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
227108
HMSA 65CP - HMSA QUEST
HI
05
—
49740502
—
HI
01
—
839943
UHA
HI
01
—
9901768599693B011
TRICARE CHAMPUS
HI
Enumeration date
07/22/2006
Last updated
07/09/2007
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