Healthcare Provider Details

I. General information

NPI: 1164596904
Provider Name (Legal Business Name): DAVID DOWHAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 10/09/2024
Certification Date: 10/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 KEOKEA PL
KULA HI
96790-7450
US

IV. Provider business mailing address

100 KEOKEA PL
KULA HI
96790-7450
US

V. Phone/Fax

Practice location:
  • Phone: 808-878-1221
  • Fax:
Mailing address:
  • Phone: 808-878-1221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD14091
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: