Healthcare Provider Details

I. General information

NPI: 1790211431
Provider Name (Legal Business Name): NASH ALLEN KAWELA WITTEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2017
Last Update Date: 01/29/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95-1249 MEHEULA PKWY
MILILANI HI
96789-1779
US

IV. Provider business mailing address

66-125 KAMEHAMEHA HWY
HALEIWA HI
96712-1601
US

V. Phone/Fax

Practice location:
  • Phone: 808-691-8511
  • Fax: 808-686-2140
Mailing address:
  • Phone: 808-691-8501
  • Fax: 808-637-4765

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD-20991
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: