DR. EDWIN F ETCUBANEZ MD NPI 1679555866

NPI Information

NPI: 1679555866
Provider Name: DR. EDWIN F ETCUBANEZ, MD
Classification: Family Medicine - 207Q00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
2100 KANOELEHUA AVE
B9
HILO, HI
ZIP 96720
Phone: (808) 981-1700
Get Directions

DR. Edwin F Etcubanez, MD is a family medicine in Hilo, HI. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR. Edwin F Etcubanez, MD NPI is 1679555866. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2100 KANOELEHUA AVE
B9
HILO, HI
ZIP 96720-500
Phone: (808) 981-1700
Fax: (808) 981-1701

The NPI 1679555866 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 11/15/2005 and was last updated on 9/10/2013.

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
1	207Q00000X	Family Medicine		4301045023	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	080D410020	OTHER	MICHIGAN	BLUE CROSS BLUE SHIELD
2	540Z90298	OTHER	MICHIGAN	HEALTH PLUS
3	0800900422	OTHER	MICHIGAN	BLUE CROSS BLUE SHIELD
4	080D410020	OTHER	MICHIGAN	BLUE CARE NETWORK
5	4433932	MEDICAID	MICHIGAN
6	D72564	MEDICARE UPIN	MICHIGAN
7	080D410020	OTHER	MICHIGAN	COMMUNITY BLUE
8	1009110	OTHER	MICHIGAN	MCLAREN HEALTH PLAN
9	1009100	OTHER	MICHIGAN	HEALTH ADVANTAGE NETWORK
10	D72564	OTHER	MICHIGAN	HEALTH NET FEDERAL SERVIC
11	OM28430115	MEDICARE ID-TYPE UNSPECIFIED	MICHIGAN
12	4395680	MEDICAID	MICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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