Provider Demographics
NPI:1841223450
Name:BADUA, MARINA AQUIRAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARINA
Middle Name:AQUIRAN
Last Name:BADUA
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 1:2164 PUNA ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-1520
Mailing Address - Country:US
Mailing Address - Phone:808-478-3400
Mailing Address - Fax:
Practice Address - Street 1:1712 LILIHA ST
Practice Address - Street 2:SUITE 202
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-5410
Practice Address - Country:US
Practice Address - Phone:808-536-1754
Practice Address - Fax:808-536-0315
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD3187207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI03829002Medicaid
H56209Medicare ID - Type Unspecified
HI03829002Medicaid