Provider Demographics
NPI:1902249725
Name:SCHOPPY, KRISTA (MD)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:
Last Name:SCHOPPY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:888 KAPIOLANI BLVD APT 2908
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-6045
Mailing Address - Country:US
Mailing Address - Phone:808-226-7943
Mailing Address - Fax:
Practice Address - Street 1:1229 YOUNG ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1916
Practice Address - Country:US
Practice Address - Phone:808-591-7702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-11
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
HIMD20673207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program