Healthcare Provider Details

I. General information

NPI: 1902172000
Provider Name (Legal Business Name): TEODORA TOPALOVSKI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2012
Last Update Date: 11/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98-1079 MOANALUA RD. FIRST FLOOR, MEDICAL STAFF SERVICES, PALI MOMI MEDICAL
AIEA HI
96701
US

IV. Provider business mailing address

95-1025 OLILIKO ST
MILILANI HI
96789
US

V. Phone/Fax

Practice location:
  • Phone: 808-485-4109
  • Fax: 808-485-4124
Mailing address:
  • Phone: 575-650-4053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number18110
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: