Provider Demographics
NPI:1154498665
Name:BEJENARU, HEATHER IRENE (MD)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:IRENE
Last Name:BEJENARU
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 1:41 E. LIPOA STREET
Mailing Address - Street 2:SUITE 21
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753
Mailing Address - Country:US
Mailing Address - Phone:808-875-0511
Mailing Address - Fax:808-875-8595
Practice Address - Street 1:161 WAILEA IKE PL STE A104
Practice Address - Street 2:
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-6502
Practice Address - Country:US
Practice Address - Phone:808-875-0511
Practice Address - Fax:808-875-8595
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI11954207N00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000238782OtherHMSA BILLING NUMBER
HIH55281Medicare PIN
HI0000238782OtherHMSA BILLING NUMBER