Healthcare Provider Details

I. General information

NPI: 1881853828
Provider Name (Legal Business Name): CAROLINE M KOLB MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAROLINE K MANS MD

II. Dates (important events)

Enumeration Date: 06/05/2008
Last Update Date: 10/20/2020
Certification Date: 10/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 JARRETT WHITE RD
TRIPLER ARMY MEDICAL CENTER HI
96859-5001
US

IV. Provider business mailing address

1 JARRETT WHITE RD
TRIPLER ARMY MEDICAL CENTER HI
96859-5001
US

V. Phone/Fax

Practice location:
  • Phone: 808-772-0901
  • Fax:
Mailing address:
  • Phone: 84-335-3348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberMD-15575
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code207YP0228X
TaxonomyPediatric Otolaryngology Physician
License NumberMD-15575
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: