Provider Demographics
NPI:1598773657
Name:AIEA INTERNAL MEDICINE SERVICES, L.L.C.
Entity Type:Organization
Organization Name:AIEA INTERNAL MEDICINE SERVICES, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:A
Authorized Official - Last Name:MIURA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-487-2277
Mailing Address - Street 1:98-1079 MOANALUA RD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-4713
Mailing Address - Country:US
Mailing Address - Phone:808-487-2277
Mailing Address - Fax:808-488-5582
Practice Address - Street 1:98-1079 MOANALUA RD
Practice Address - Street 2:SUITE 350
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-4713
Practice Address - Country:US
Practice Address - Phone:808-487-2277
Practice Address - Fax:808-488-5582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI52327OtherGROUP NUMBER