Healthcare Provider Details

I. General information

NPI: 1487698924
Provider Name (Legal Business Name): STEVEN ROGOFF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 08/01/2022
Certification Date: 08/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2460 OKA ST
KILAUEA HI
96754-5308
US

IV. Provider business mailing address

4111C KILAUEA RD
KILAUEA HI
96754-5217
US

V. Phone/Fax

Practice location:
  • Phone: 808-828-2885
  • Fax: 808-828-0119
Mailing address:
  • Phone: 808-651-0839
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD-11990
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: