Healthcare Provider Details
I. General information
NPI: 1902249725
Provider Name (Legal Business Name): KRISTA SCHOPPY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/11/2013
Last Update Date: 01/17/2020
Certification Date: 01/17/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1229 YOUNG ST
HONOLULU HI
96814-1916
US
IV. Provider business mailing address
888 KAPIOLANI BLVD APT 2908
HONOLULU HI
96813-6045
US
V. Phone/Fax
- Phone: 808-591-7702
- Fax:
- Phone: 808-226-7943
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Y00000X |
| Taxonomy | Otolaryngology Physician |
| License Number | MD20673 |
| License Number State | HI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: