Healthcare Provider Details

I. General information

NPI: 1477653541
Provider Name (Legal Business Name): MAUREEN C. MAGUIRE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 10/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 MAUILANI PKWY
WAILUKU HI
96793-2416
US

IV. Provider business mailing address

55 MAUILANI PKWY
WAILUKU HI
96793-2416
US

V. Phone/Fax

Practice location:
  • Phone: 808-243-6050
  • Fax:
Mailing address:
  • Phone: 808-243-6050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberMD-7289
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: