Provider Demographics
NPI:1407844905
Name:MEILY, MARY IRIS (MD)
Entity Type:Individual
Prefix:
First Name:MARY IRIS
Middle Name:
Last Name:MEILY
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 1:4300 WAIALAE AVE
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-5761
Mailing Address - Country:US
Mailing Address - Phone:808-732-6259
Mailing Address - Fax:
Practice Address - Street 1:NAVAL MEDICAL CLINIC
Practice Address - Street 2:480 CENTRAL AVENUE
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96860
Practice Address - Country:US
Practice Address - Phone:808-473-1880
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI8876208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics