| Maui Family Medicine | |
|
285 W Kaahumanu Ave Ste 205 Kahului HI 96732-1623 | |
| (808) 351-2865 | |
| (914) 222-8916 |
| Full Name | Maui Family Medicine |
|---|---|
| Speciality | Clinic/Center |
| Location | 285 W Kaahumanu Ave Ste 205, Kahului, Hawaii |
| Authorized Official Name and Position | Ivy Lou Hibbitt (CEO/ MEDICAL DIRECTOR) |
| Authorized Official Contact | 8082128787 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maui Family Medicine 26 Hoku Puhipaka St Kahului HI 96732-4527 Ph: (808) 212-8787 | Maui Family Medicine 285 W Kaahumanu Ave Ste 205 Kahului HI 96732-1623 Ph: (808) 351-2865 |
| NPI Number | 1710511993 |
|---|---|
| Provider Enumeration Date | 02/26/2020 |
| Last Update Date | 08/12/2020 |
| Medicare PECOS PAC ID | 4789061870 |
|---|---|
| Medicare Enrollment ID | O20220511000155 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710511993 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Ivy Lou Hibbitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043767726 PECOS PAC ID: 5294007803 Enrollment ID: I20170816003810 |
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