Provider Demographics
NPI:1487698924
Name:ROGOFF, STEVEN (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:ROGOFF
Suffix:
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 1:4111C KILAUEA RD
Mailing Address - Street 2:
Mailing Address - City:KILAUEA
Mailing Address - State:HI
Mailing Address - Zip Code:96754-5217
Mailing Address - Country:US
Mailing Address - Phone:808-651-0839
Mailing Address - Fax:
Practice Address - Street 1:2460 OKA ST
Practice Address - Street 2:
Practice Address - City:KILAUEA
Practice Address - State:HI
Practice Address - Zip Code:96754-5308
Practice Address - Country:US
Practice Address - Phone:808-828-2885
Practice Address - Fax:808-828-0119
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-11990207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIA23940-8OtherHMSA
HI538275Medicaid
HI538275Medicaid
HIH80803Medicare UPIN