Provider Demographics
NPI:1215145057
Name:RIMM, MICHAEL LAWRENCE (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:LAWRENCE
Last Name:RIMM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:324 LILIUOKALANI ST
Mailing Address - Street 2:
Mailing Address - City:MAKAWAO
Mailing Address - State:HI
Mailing Address - Zip Code:96768-8633
Mailing Address - Country:US
Mailing Address - Phone:808-268-2805
Mailing Address - Fax:
Practice Address - Street 1:1043 MAKAWAO AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:MAKAWAO
Practice Address - State:HI
Practice Address - Zip Code:96768-9465
Practice Address - Country:US
Practice Address - Phone:808-268-2805
Practice Address - Fax:808-572-4500
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD122432084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000244525OtherPIN HMSA