Healthcare Provider Details

I. General information

NPI: 1104053388
Provider Name (Legal Business Name): KRISTER PAUL FREESE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2009
Last Update Date: 04/29/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1356 LUSITANA STREET 6TH FLOOR
HONOLULU HI
96813-2421
US

IV. Provider business mailing address

1356 LUSITANA STREET 6TH FLOOR
HONOLULU HI
96813-2421
US

V. Phone/Fax

Practice location:
  • Phone: 808-586-8232
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMDR-5742
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License NumberMD176505
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberMD176505
License Number StateOR
# 4
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD176505
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: