Healthcare Provider Details

I. General information

NPI: 1891993846
Provider Name (Legal Business Name): BRIGITTE A CARREAU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2007
Last Update Date: 05/18/2009
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

1946 YOUNG ST SUITE 320
HONOLULU HI
96826-2169
US

V. Phone/Fax

Practice location:
  • Phone: 808-245-1500
  • Fax:
Mailing address:
  • Phone: 808-973-7320
  • Fax: 808-973-7325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD-15057
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: