Healthcare Provider Details

I. General information

NPI: 1982822862
Provider Name (Legal Business Name): DAVID S CROW MD PHD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 02/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1830 WELLS ST SUITE 103
WAILUKU HI
96793-2365
US

IV. Provider business mailing address

1830 WELLS ST SUITE 103
WAILUKU HI
96793-2365
US

V. Phone/Fax

Practice location:
  • Phone: 808-244-4910
  • Fax: 808-244-1295
Mailing address:
  • Phone: 808-244-4910
  • Fax: 808-244-1295

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YP0228X
TaxonomyPediatric Otolaryngology Physician
License NumberMD-11100
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License NumberMD-11100
License Number StateHI
# 3
Primary TaxonomyN
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License NumberMD-11100
License Number StateHI
# 4
Primary TaxonomyN
Taxonomy Code207YX0602X
TaxonomyOtolaryngic Allergy Physician
License NumberMD-11100
License Number StateHI
# 5
Primary TaxonomyN
Taxonomy Code207YX0901X
TaxonomyOtology & Neurotology Physician
License NumberMD-11100
License Number StateHI
# 6
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License NumberMD-11100
License Number StateHI

VIII. Authorized Official

Name: DR. DAVID SCOTT CROW
Title or Position: OWNER
Credential: M.D.
Phone: 808-244-4910