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General NPI Number Information
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NPI Number | 1962929398
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Entity Type | Organization
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Legal Business Name | MARK T. KUGE,MD,INC
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Dates
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Enumeration Date | 08/25/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1481 S KING ST STE 310
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City | HONOLULU
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State | HI
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Zip | 96814-2684
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Country | US
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Telephone | 808-947-2844
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Fax | 808-944-8472
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Provider Business Mailing Address
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Address Line | 1481 S KING ST STE 310
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City | HONOLULU
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State | HI
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Zip | 96814-2684
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Country | US
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Telephone | 808-947-2844
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Fax | 808-944-8472
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARK T. KUGE
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Credential | MD
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Telephone | 808-230-3719
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 2480
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License Number State | HI
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