Provider Demographics
NPI:1194733287
Name:MAUI RADIOLOGY ASSOCIATES
Entity type:Organization
Organization Name:MAUI RADIOLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:STEINFELDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-269-0417
Mailing Address - Street 1:221 MAHALANI ST
Mailing Address - Street 2:RADIOLOGY DEPARTMENT
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-2526
Mailing Address - Country:US
Mailing Address - Phone:404-494-4683
Mailing Address - Fax:808-871-5587
Practice Address - Street 1:221 MAHALANI ST
Practice Address - Street 2:RADIOLOGY DEPARTMENT
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-2526
Practice Address - Country:US
Practice Address - Phone:808-244-9056
Practice Address - Fax:808-871-5587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH56185Medicare PIN