| Orchid Isle Neurology, Llc | |
|
67-1123 Mamalahoa Hwy Suite 110 Kamuela HI 96743-8451 | |
| (808) 885-9308 | |
| (808) 885-9310 |
| Full Name | Orchid Isle Neurology, Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 67-1123 Mamalahoa Hwy, Kamuela, Hawaii |
| Authorized Official Name and Position | Norifusa John Anegawa (OWNER) |
| Authorized Official Contact | 8088859308 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Orchid Isle Neurology, Llc Po Box 437319 Kamuela HI 96743-7143 Ph: (808) 885-9308 | Orchid Isle Neurology, Llc 67-1123 Mamalahoa Hwy Suite 110 Kamuela HI 96743-8451 Ph: (808) 885-9308 |
| NPI Number | 1740354232 |
|---|---|
| Provider Enumeration Date | 11/17/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740354232 | NPI | - | NPPES |
| 100371 | Medicaid | HI | |
| DD5219 | Other | HI | RAILROAD MEDICARE GROUP |
| 0000252148 | Other | HI | HMSA ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 13015 (Hawaii) | Primary |
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