Healthcare Provider Details

I. General information

NPI: 1144267568
Provider Name (Legal Business Name): CHARLOTTE L HUNTER MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2490 OKA ST
KILAUEA HI
96754-5332
US

IV. Provider business mailing address

2490 OKA ST
KILAUEA HI
96754-5332
US

V. Phone/Fax

Practice location:
  • Phone: 808-828-1418
  • Fax: 808-828-1666
Mailing address:
  • Phone: 808-828-1418
  • Fax: 808-828-1666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD10874
License Number StateHI

VIII. Authorized Official

Name: CHARLOTTE LOUISE HUNTER
Title or Position: PRESIDENT
Credential: MD
Phone: 808-828-1418