Individual provider · NPI-1

Kyle E. Mouery, MD

Family Medicine · Lahaina, HI

NPI number1699094391

StatusActive

Last updated in NPPESJun 2, 2021

Details

NPI: 1699094391
Entity type: Individual (NPI-1)
Name: Kyle E. Mouery
Credential: MD
Sex: Male
Sole proprietor: No
Enumeration date: May 20, 2010
Certification date: Jun 2, 2021
Last updated: Jun 2, 2021

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207Q00000X	Family Medicine	MD-19448	HI	Yes
207Q00000X	Family Medicine	MD164064	OR
390200000X	Student in an Organized Health Care Education/Training Program	PG151890	OR

Practice location

910 Wainee St
Lahaina, HI 96761-1622

Phone 808-662-6900

Mailing address

910 Wainee St
Lahaina, HI 96761-1622

Phone 808-662-6900

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