Healthcare Provider Details

I. General information

NPI: 1790893451
Provider Name (Legal Business Name): MICHAEL A MCMANN M.D., LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91-2139 FORT WEAVER RD SUITE 202
EWA BEACH HI
96706-3608
US

IV. Provider business mailing address

91-2139 FORT WEAVER RD SUITE 202
EWA BEACH HI
96706-3607
US

V. Phone/Fax

Practice location:
  • Phone: 808-677-2733
  • Fax: 808-441-7737
Mailing address:
  • Phone: 808-677-2733
  • Fax: 808-441-7737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD-10374
License Number StateHI

VIII. Authorized Official

Name: DR. MICHAEL ARTHUR MCMANN
Title or Position: MANAGER & OWNER
Credential: MD
Phone: 808-489-3154