Basic Information
| Provider Information | |||||||||
| NPI: | 1710324892 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KUIKKA | ||||||||
| FirstName: | MARCUS | ||||||||
| MiddleName: | ALEKSANDER | ||||||||
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| Credential: | MBBS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 151 E WAKEA AVE STE 202 | ||||||||
| Address2: | |||||||||
| City: | KAHULUI | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967322475 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8085383232 | ||||||||
| FaxNumber: | 8085383220 | ||||||||
| Practice Location | |||||||||
| Address1: | 221 MAHALANI ST | ||||||||
| Address2: | |||||||||
| City: | WAILUKU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 96793 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8082449056 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/29/2013 | ||||||||
| LastUpdateDate: | 07/11/2018 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | 03/31/2014 | ||||||||
| NPIReactivationDate: | 04/23/2014 | ||||||||
| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | MD19661 | HI | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.