Healthcare Provider Details

I. General information

NPI: 1407946015
Provider Name (Legal Business Name): SCOTT K. KUWADA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 09/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 SOUTH BERETANIA STREET SUITE 510
HONOLULU HI
96813-2496
US

IV. Provider business mailing address

550 SOUTH BERETANIA STREET SUITE 510
HONOLULU HI
96813-2496
US

V. Phone/Fax

Practice location:
  • Phone: 808-691-8955
  • Fax:
Mailing address:
  • Phone: 808-691-8955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number10847
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: