Provider Demographics
NPI:1437371564
Name:SUEHIRO, MYLES (MD)
Entity Type:Individual
Prefix:DR
First Name:MYLES
Middle Name:
Last Name:SUEHIRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3784 KUMULANI PL
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96822-1112
Mailing Address - Country:US
Mailing Address - Phone:808-372-5111
Mailing Address - Fax:808-988-5090
Practice Address - Street 1:1585 KAPIOLANI BLVD
Practice Address - Street 2:SUITE 1645
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-4522
Practice Address - Country:US
Practice Address - Phone:808-372-5111
Practice Address - Fax:808-988-5090
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI3777207RP1001X, 207RS0012X, 207RS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI021218Medicaid
HIC98641Medicare UPIN
HIH0000BDNBMMedicare ID - Type UnspecifiedMEDICARE PROVIDER #