Provider Demographics
NPI:1871534321
Name:MCCAFFREY, DAVID SCOTT (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:SCOTT
Last Name:MCCAFFREY
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 1:91-2135 FORT WEAVER RD
Mailing Address - Street 2:SUITE 170
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-1940
Mailing Address - Country:US
Mailing Address - Phone:808-676-5331
Mailing Address - Fax:808-671-2931
Practice Address - Street 1:91-2135 FORT WEAVER RD
Practice Address - Street 2:SUITE 170
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-1940
Practice Address - Country:US
Practice Address - Phone:808-676-5331
Practice Address - Fax:808-671-2931
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD54732083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00E002451-2OtherHMSA
HI02217501Medicaid
HIC-97498Medicare UPIN
HI02217501Medicaid