Healthcare Provider Details

I. General information

NPI: 1306896345
Provider Name (Legal Business Name): RICHARD M MCDOWELL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

79-1019 HAUKAPILA ST
KEALAKEKUA HI
96750-7920
US

IV. Provider business mailing address

75-816 HIONA ST #D
HOLUALOA HI
96725-8607
US

V. Phone/Fax

Practice location:
  • Phone: 808-322-4413
  • Fax:
Mailing address:
  • Phone: 808-326-1652
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License NumberMD11547
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: