Provider Demographics
NPI:1427145234
Name:DAVIS, DANIEL COLE JR (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:COLE
Last Name:DAVIS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1380 LUSITANA, SUITE 804
Mailing Address - Street 2:MEDICAL ASSOCIATES LTD
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813
Mailing Address - Country:US
Mailing Address - Phone:808-524-3020
Mailing Address - Fax:808-524-8163
Practice Address - Street 1:1380 LUSITANA, SUITE 804
Practice Address - Street 2:MEDICAL ASSOCIATES LTD
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813
Practice Address - Country:US
Practice Address - Phone:808-524-3020
Practice Address - Fax:808-524-8163
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI5394207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HID43557Medicare UPIN