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1558348359

NPI Code Detail

MEDICARE: DR. DON L HALOUSKA M.D.

MEDICARE: DR. DON L HALOUSKA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	19634	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	300064740	OTHER	CO	RR MCRE RIA
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	300064090	OTHER	CO	RR MCRE MIC
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	300090374	OTHER	CO	RR MCRE DIA
13	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558348359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DON L HALOUSKA M.D.

Provider Business Mailing Address
First Line	:	2180 MAIN ST
Second Line	:
City	:	WAILUKU
State	:	HI
Zip	:	96793-1625
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2180 MAIN ST
Second Line	:
City	:	WAILUKU
State	:	HI
Zip	:	96793-1625
Country	:	US
Telephone Number	:	808-242-6464
Fax Number	:	808-242-4210

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2005
Last Update Date	:	09/09/2010

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Directions to “ DR. DON L HALOUSKA M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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