Healthcare Provider Details

I. General information

NPI: 1104038249
Provider Name (Legal Business Name): SHAUN C DONEGAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 N KUAKINI ST STE 412
HONOLULU HI
96817-2360
US

IV. Provider business mailing address

321 N KUAKINI ST STE 404
HONOLULU HI
96817-2360
US

V. Phone/Fax

Practice location:
  • Phone: 808-531-8521
  • Fax:
Mailing address:
  • Phone: 808-772-4743
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberMD-23173
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: