Provider Demographics
NPI:1114589900
Name:CARTER, KANA MAEJI (DO)
Entity type:Individual
Prefix:
First Name:KANA
Middle Name:MAEJI
Last Name:CARTER
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:KANA
Other - Middle Name:
Other - Last Name:MAEJI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:98-1005 MOANGLUA ROAD
Mailing Address - Street 2:SUITE 3030
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701
Mailing Address - Country:US
Mailing Address - Phone:808-627-3200
Mailing Address - Fax:808-623-7872
Practice Address - Street 1:98-1005 MOANGLUA ROAD
Practice Address - Street 2:SUITE 3030
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701
Practice Address - Country:US
Practice Address - Phone:808-627-3200
Practice Address - Fax:808-623-7872
Is Sole Proprietor?:No
Enumeration Date:2019-07-02
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDOS-2400207QS0010X, 207Q00000X
HIDOSR-492207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIDOSR-492OtherMDR