Provider Demographics
NPI:1174660682
Name:MIKI, KINUE (MD)
Entity Type:Individual
Prefix:MRS
First Name:KINUE
Middle Name:
Last Name:MIKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2228 LILIHA ST
Mailing Address - Street 2:STE 300
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-1653
Mailing Address - Country:US
Mailing Address - Phone:808-521-5220
Mailing Address - Fax:808-441-5588
Practice Address - Street 1:2228 LILIHA ST
Practice Address - Street 2:STE 300
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-1653
Practice Address - Country:US
Practice Address - Phone:808-521-5220
Practice Address - Fax:808-441-5588
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2017-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD7370207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
990351287OtherFEDERAL TAX ID NUMBER
HI151578Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
F79685Medicare UPIN