Organization
MAUNA KEA MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN DOUGLAS STOVER (DELEGATED OFFICIAL)
(808) 960-5412
Entity
Organization
Contact information
Practice address
64-1035 MAMALAHOA HWY STE K, KAMUELA, HI 96743-8440
(808) 883-9785
(808) 883-9683
Mailing address
64-1035 MAMALAHOA HWY STE K, KAMUELA, HI 96743-8440
(808) 883-9785
(808) 883-9683
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
18437
HI
Other
Enumeration date
01/24/2018
Last updated
01/24/2018
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