Provider Demographics
NPI:1063575801
Name:MINN, CAROL E (MD)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:E
Last Name:MINN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1700 LANAKILA AVE
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-2115
Mailing Address - Country:US
Mailing Address - Phone:808-832-3823
Mailing Address - Fax:808-832-5966
Practice Address - Street 1:860 FOURTH ST
Practice Address - Street 2:
Practice Address - City:PEARL CITY
Practice Address - State:HI
Practice Address - Zip Code:96782-3312
Practice Address - Country:US
Practice Address - Phone:808-453-5953
Practice Address - Fax:808-453-5966
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-61002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIA0211795OtherHMSA PIN
HI4270OtherALOHA CARE
HIA0211795OtherHMSA PIN