| Aiea Medical Group,llc | |
|
98-1079 Moanalua Rd Suite 420 Aiea HI 96701-4713 | |
| (808) 488-7770 | |
| Not Available |
| Full Name | Aiea Medical Group,llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 98-1079 Moanalua Rd, Aiea, Hawaii |
| Authorized Official Name and Position | Michael John Dimitrion (PRESIDENT) |
| Authorized Official Contact | 8084887770 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Aiea Medical Group,llc 98-1079 Moanalua Rd Suite 420 Aiea HI 96701-4713 Ph: (808) 488-7770 | Aiea Medical Group,llc 98-1079 Moanalua Rd Suite 420 Aiea HI 96701-4713 Ph: (808) 488-7770 |
| NPI Number | 1598009227 |
|---|---|
| Provider Enumeration Date | 11/19/2012 |
| Last Update Date | 11/19/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598009227 | NPI | - | NPPES |
| 03759701 | Medicaid | HI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 3107 (Hawaii) | Primary |
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