Healthcare Provider Details

I. General information

NPI: 1528386299
Provider Name (Legal Business Name): DAVID M HUNTLEY MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2010
Last Update Date: 08/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 ULUNIU ST #314
KAILUA HI
96734-2519
US

IV. Provider business mailing address

407 ULUNIU ST #314
KAILUA HI
96734-2519
US

V. Phone/Fax

Practice location:
  • Phone: 808-261-2700
  • Fax: 808-263-8513
Mailing address:
  • Phone: 808-261-2700
  • Fax: 808-263-8513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License NumberMD2753
License Number StateHI

VIII. Authorized Official

Name: DR. DAVID M HUNTLEY
Title or Position: PRESIDENT
Credential: M.D.
Phone: 808-261-2700