Healthcare Provider Details

I. General information

NPI: 1093583353
Provider Name (Legal Business Name): SUMMER K M DUNHOUR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2023
Last Update Date: 01/09/2024
Certification Date: 01/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 KAINEHE ST STE 205
KAILUA HI
96734-2670
US

IV. Provider business mailing address

32 KAINEHE ST STE 205
KAILUA HI
96734-2670
US

V. Phone/Fax

Practice location:
  • Phone: 808-561-9282
  • Fax:
Mailing address:
  • Phone: 808-561-9282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License NumberBSH-5693
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: