Individual
SUSANNAH KERR MISTR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
68-1845 WAIKOLOA RD, SUITE 218, WAIKOLOA, HI 96738-5584
(808) 883-3767
Mailing address
PO BOX 383147, WAIKOLOA, HI 96738-3147
(808) 883-3767
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD 15669
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
645070
—
HI
01
—
P00926555
RR MEDICARE
HI
Enumeration date
06/05/2007
Last updated
03/02/2015
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