Healthcare Provider Details

I. General information

NPI: 1528163284
Provider Name (Legal Business Name): DAVID ROVINSKY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 10/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3-3420 KUHIO HWY SUITE B
LIHUE HI
96766-1098
US

IV. Provider business mailing address

3-3420 KUHIO HIGHWAY SUITE B
LIHUE HI
96766-1098
US

V. Phone/Fax

Practice location:
  • Phone: 808-245-1524
  • Fax: 808-246-1361
Mailing address:
  • Phone: 808-245-1524
  • Fax: 808-246-1361

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD-11077
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD A061370
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: