Healthcare Provider Details

I. General information

NPI: 1497866800
Provider Name (Legal Business Name): MARY ANN HOLLMAN MD, MS, CIME
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 12/31/2021
Certification Date: 12/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 HANA HWY STE 107
KAHULUI HI
96732-2300
US

IV. Provider business mailing address

148 MOLEHULEHU LOOP
KAHULUI HI
96732-4511
US

V. Phone/Fax

Practice location:
  • Phone: 808-205-0603
  • Fax: 808-419-6493
Mailing address:
  • Phone: 808-205-0603
  • Fax: 808-419-6493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License NumberR9N85
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License NumberMD-18668
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: