Individual
VICTORIA BABUSHKINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2180 MAIN ST, WAILUKU, HI 96793-1625
(808) 242-6464
(808) 442-5512
Mailing address
2180 MAIN ST, WAILUKU, HI 96793-1625
(808) 242-6464
(808) 442-5512
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
21033
SC
207R00000X
Internal Medicine Physician
Primary
MD-16875
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
194179
MEDCOST
SC
05
—
210337
—
SC
01
—
5004135
AETNA
SC
01
—
GZ952Z
MEDICARE ID
HI
01
—
P00708599
RR MEDICARE
SC
Enumeration date
04/18/2006
Last updated
09/16/2013
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