Provider Demographics
NPI:1104025816
Name:TERUYA, NINA MIWAKO (MD)
Entity Type:Individual
Prefix:DR
First Name:NINA
Middle Name:MIWAKO
Last Name:TERUYA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NINA
Other - Middle Name:MIWAKO
Other - Last Name:TERUYA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1319 PUNAHOU ST
Mailing Address - Street 2:STE. 1050
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-1001
Mailing Address - Country:US
Mailing Address - Phone:808-942-8144
Mailing Address - Fax:808-955-3827
Practice Address - Street 1:1319 PUNAHOU ST
Practice Address - Street 2:STE. 1050
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-1001
Practice Address - Country:US
Practice Address - Phone:808-942-8144
Practice Address - Fax:808-955-3827
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-12
Last Update Date:2012-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI15204208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics