Provider Demographics
NPI:1104911429
Name:FERNANDES, RITABELLE (MD)
Entity type:Individual
Prefix:MS
First Name:RITABELLE
Middle Name:
Last Name:FERNANDES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 N KING ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-4544
Mailing Address - Country:US
Mailing Address - Phone:808-791-9400
Mailing Address - Fax:808-848-0979
Practice Address - Street 1:2239 N SCHOOL ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-2539
Practice Address - Country:US
Practice Address - Phone:808-791-9400
Practice Address - Fax:808-848-0979
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2016-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-10677207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000231431OtherHMSA - BLUE CROSS
HI0000992101Medicaid
HIMD10677OtherMDX
HI005005210OtherALOHACARE
HI0000231431OtherHMSA - BLUE CROSS