Provider Demographics
NPI:1043242209
Name:ARRUDA, NOLAN (MD)
Entity type:Individual
Prefix:DR
First Name:NOLAN
Middle Name:
Last Name:ARRUDA
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 1:2180 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-1625
Mailing Address - Country:US
Mailing Address - Phone:808-242-6464
Mailing Address - Fax:
Practice Address - Street 1:2180 MAIN ST
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-1625
Practice Address - Country:US
Practice Address - Phone:808-242-6464
Practice Address - Fax:808-243-2344
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD6976207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI06838601OtherALOHA CARE QUEST
HI06838601Medicaid
HI795843OtherUHA
HI088864OtherHMSA - 65CP - HMSA QUEST
HI99017685996793B074OtherTRICARE- CHAMPUS
HI088864OtherHMSA - 65CP - HMSA QUEST
HI06838601Medicaid