Healthcare Provider Details

I. General information

NPI: 1841227907
Provider Name (Legal Business Name): CHRISTOPHER B. STEFANELLI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 06/02/2021
Certification Date: 06/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3288 MOANALUA RD
HONOLULU HI
96819-1469
US

IV. Provider business mailing address

3288 MOANALUA RD
HONOLULU HI
96819-1469
US

V. Phone/Fax

Practice location:
  • Phone: 808-432-8011
  • Fax: 808-432-8040
Mailing address:
  • Phone: 808-432-8011
  • Fax: 808-432-8040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number16528
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: