Provider Demographics
NPI:1447450077
Name:ALOHA NUI FAMILY PRACTICE, LLC
Entity type:Organization
Organization Name:ALOHA NUI FAMILY PRACTICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:STEFAN
Authorized Official - Middle Name:CARL
Authorized Official - Last Name:HARMELING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-961-1400
Mailing Address - Street 1:69 LANIHULI ST
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-4142
Mailing Address - Country:US
Mailing Address - Phone:808-961-1400
Mailing Address - Fax:808-961-1300
Practice Address - Street 1:69 LANIHULI ST
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-4142
Practice Address - Country:US
Practice Address - Phone:808-961-1400
Practice Address - Fax:808-961-1300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-23
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIH13250261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI567901-08Medicaid