Provider Demographics
NPI:1548331184
Name:TERDIK, KATALIN J (DO)
Entity type:Individual
Prefix:DR
First Name:KATALIN
Middle Name:J
Last Name:TERDIK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3-3420 KUHIO HIGHWAY
Mailing Address - Street 2:SUITE B
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766-1098
Mailing Address - Country:US
Mailing Address - Phone:808-245-1100
Mailing Address - Fax:
Practice Address - Street 1:3-3420 KUHIO HWY
Practice Address - Street 2:SUITE B
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1098
Practice Address - Country:US
Practice Address - Phone:808-245-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDOS-1075208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI574097 01Medicaid
HI0000255810OtherHMSA
HI907456OtherUHA
HI907456OtherUHA
HII44058Medicare UPIN