Provider Demographics
NPI:1336116706
Name:MIYASHIRO, MICHELLE H (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:H
Last Name:MIYASHIRO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1329 LUSITANA ST
Mailing Address - Street 2:#307
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2429
Mailing Address - Country:US
Mailing Address - Phone:808-524-6115
Mailing Address - Fax:808-528-1711
Practice Address - Street 1:1650 LILIHA ST
Practice Address - Street 2:#105
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-3169
Practice Address - Country:US
Practice Address - Phone:808-524-3131
Practice Address - Fax:808-524-3189
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HIMD12484207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI53419001Medicaid
HI0241240OtherHMSA
HIH50026Medicare PIN
HIH76369Medicare UPIN