MAUI UROLOGY LLC NPI 1073179669

NPI Information

  • NPI: 1073179669
  • Provider Name: MAUI UROLOGY, LLC
  • Classification: Urology - 208800000X
  • Entity Type: Organization
  • CLIA Number: 12D2163494
  • Address: 1883 MILL ST
    WAILUKU, HI
    ZIP 96793
  • Phone: (808) 242-8765

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NPI Details

MAUI UROLOGY, LLC is an urology in Wailuku, HI. The provider is a urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. MAUI UROLOGY, LLC NPI is 1073179669. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1883 MILL ST
WAILUKU, HI
ZIP 96793-236
Phone: (808) 242-8765
Fax: (808) 242-8769

The provider's authorized official is Stephanie Carlsen .
The authorized official title is Acting Administrator and has the following contact phone number (808) 242-8765.

The CLIA number assigned to this NPI record is 12D2163494 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/19/2019 and was last updated on 5/19/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208800000XUrologyYes

What is NPI?

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This page was last updated on: 11/21/2025

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