Healthcare Provider Details
I. General information
NPI: 1104751080
Provider Name (Legal Business Name): RYAN ADELL MD INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/15/2026
Last Update Date: 06/27/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
200 NORTH VINEYARD BLVD STE A325 BOX 543
HONOLULU HI
96817
US
IV. Provider business mailing address
200 NORTH VINEYARD BLVD SUITE A325 UNIT 543
HONOLULU HI
96817
US
V. Phone/Fax
- Phone: 440-289-8981
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RYAN
S
ADELL
Title or Position: OWNER
Credential: MD
Phone: 440-289-8981