Healthcare Provider Details

I. General information

NPI: 1114287828
Provider Name (Legal Business Name): JOSHUA CHARLES STARBUCK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2012
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 WAILEA IKE PL STE C104
KIHEI HI
96753-6523
US

IV. Provider business mailing address

161 WAILEA IKE PL STE C104
KIHEI HI
96753-6523
US

V. Phone/Fax

Practice location:
  • Phone: 808-217-8447
  • Fax: 808-400-5891
Mailing address:
  • Phone: 808-633-5539
  • Fax: 808-400-5891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD-18293
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: