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General NPI Number Information
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NPI Number | 1538072814
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Entity Type | Organization
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Legal Business Name | KOLOA DPC LLC
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Dates
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Enumeration Date | 09/25/2026
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Last Update Date | 09/25/2026
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Provider Practice Location Address
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Address Line | 5460 KOLOA RD STE G2O2
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City | KOLOA
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State | HI
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Zip | 96756-9421
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Country | US
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Telephone | 802-355-7479
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1887
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City | KOLOA
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State | HI
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Zip | 96756-1887
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Country | US
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Telephone | 802-355-7479
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Fax | 808-309-6625
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Authorized Official
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Title or Position | MD
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Name | MOLLY REBECCA HEUBLEIN
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Credential | MD
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Telephone | 802-355-7479
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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