Sides, Douglas Mitchell

Sides, Douglas Mitchell is an individual health care provider with primary practice located at 688 Kinoole St Suite 103, Hilo HI 96720. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Sides, Douglas Mitchell can be contacted via phone (808) 935-1825.

Contact Information

Primary practice address
688 Kinoole St Suite 103 Hilo HI 96720
Phone: (808) 935-1825
Fax: (903) 663-7394
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X G76456 California
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X G76456 California
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 10716 Nevada

Profile Details

NPI number 1144228255
LBN Legal business name Sides, Douglas Mitchell
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2005
Last updated Nov 8th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144228255 NPPES
Arizona MEDICAID 905838
Arizona Other CC5535
Arizona MEDICAID 100502411

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