Provider Demographics
NPI:1356524649
Name:MARK W. GRIEF, M.D., INC.
Entity type:Organization
Organization Name:MARK W. GRIEF, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN/ BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIEF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-488-7797
Mailing Address - Street 1:98-1079 MOANALUA RD STE 580
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-4716
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:98-1079 MOANALUA RD STE 580
Practice Address - Street 2:
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-4716
Practice Address - Country:US
Practice Address - Phone:808-488-7797
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-10
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI6079208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIE57474Medicare UPIN