Healthcare Provider Details

I. General information

NPI: 1144683012
Provider Name (Legal Business Name): TARA REED M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2016
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

868 ULULANI ST STE 102
HILO HI
96720-3913
US

IV. Provider business mailing address

868 ULULANI ST STE 102
HILO HI
96720-3913
US

V. Phone/Fax

Practice location:
  • Phone: 808-969-1671
  • Fax:
Mailing address:
  • Phone: 808-969-1671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD-20482
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: