Healthcare Provider Details

I. General information

NPI: 1770013971
Provider Name (Legal Business Name): NARUT PRASITLUMKUM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2017
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98-1079 MOANALUA RD, STE 680 PALI MOMI HEART CENTER
AIEA HI
96701
US

IV. Provider business mailing address

98-1079 MOANALUA RD, STE 680 PALI MOMI HEART CENTER
AIEA HI
96701-4725
US

V. Phone/Fax

Practice location:
  • Phone: 808-485-4553
  • Fax: 808-485-4447
Mailing address:
  • Phone: 808-485-4553
  • Fax: 808-485-4447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberMD-25112
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: