Individual
DEREK R ILLASTRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
110 E KAAHUMANU AVE, KAHULUI, HI 96732-2118
(808) 242-6464
(808) 243-2367
Mailing address
2180 MAIN ST, WAILUKU, HI 96793-1625
(808) 242-6464
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
235414
MA
207R00000X
Internal Medicine Physician
Primary
MD-18353
HI
Other
Enumeration date
07/16/2008
Last updated
03/19/2019
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