Provider Demographics
NPI:1124107404
Name:KAWUT, HONI (D,C,)
Entity type:Individual
Prefix:DR
First Name:HONI
Middle Name:
Last Name:KAWUT
Suffix:
Gender:F
Credentials:D,C,
Other - Prefix:DR
Other - First Name:HONI
Other - Middle Name:
Other - Last Name:KAWUT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:25 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:BILLERICA
Mailing Address - State:MA
Mailing Address - Zip Code:01821-1023
Mailing Address - Country:US
Mailing Address - Phone:978-667-1932
Mailing Address - Fax:
Practice Address - Street 1:25 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:BILLERICA
Practice Address - State:MA
Practice Address - Zip Code:01821-1023
Practice Address - Country:US
Practice Address - Phone:978-667-1932
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1271111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA730544OtherTUFTS
MA730544OtherSECURE HORIZONS
MA351052OtherHARVARD PILGRIM
MA351052OtherFIRST SENIORITY
MAY35920OtherBLUE CROSS/BLUE SHIELD
MA730544OtherTUFTS
MA351052OtherHARVARD PILGRIM