Provider Demographics
NPI:1104091297
Name:COLES, ADAM ALLAN (MD)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:ALLAN
Last Name:COLES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3627 KILAUEA AVE RM 101
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-2317
Mailing Address - Country:US
Mailing Address - Phone:808-733-7997
Mailing Address - Fax:808-733-9357
Practice Address - Street 1:3627 KILAUEA AVE RM 101
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-2317
Practice Address - Country:US
Practice Address - Phone:808-733-7997
Practice Address - Fax:808-733-9357
Is Sole Proprietor?:No
Enumeration Date:2008-04-29
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO499652084P0800X
HIMD-18417174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry