Provider Demographics
NPI:1194747493
Name:KING, STEVEN AUGUST (DPM)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:AUGUST
Last Name:KING
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2180 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-1666
Mailing Address - Country:US
Mailing Address - Phone:808-242-6464
Mailing Address - Fax:808-243-2345
Practice Address - Street 1:717 S STATE ST STE 900
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:MN
Practice Address - Zip Code:56031-4469
Practice Address - Country:US
Practice Address - Phone:507-238-4949
Practice Address - Fax:507-238-3365
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPO137213E00000X
MN1134213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI99017685996793B057OtherTRICARE - CHAMPUS
HI51014OtherUHA
HI222158OtherHMSA - 65CP - HMSA QUEST
HIH51228Medicare PIN
HI99017685996793B057OtherTRICARE - CHAMPUS
HI51014OtherUHA