Provider Demographics
NPI:1144299264
Name:VIGIL, MICHAEL ARTHUR (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ARTHUR
Last Name:VIGIL
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 1:75-5751 KUAKINI HWY STE 203
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-1753
Mailing Address - Country:US
Mailing Address - Phone:808-327-1939
Mailing Address - Fax:
Practice Address - Street 1:75-5751 KUAKINI HWY STE 203
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-1753
Practice Address - Country:US
Practice Address - Phone:505-524-8711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM82-147207Q00000X
AZ12824207Q00000X
HI13041207Q00000X
IDM-8618208D00000X
AK4093208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM2132891Medicare ID - Type Unspecified
NMD43342Medicare UPIN