Provider Demographics
NPI:1508898404
Name:COLEMAN, MAILA A (MD)
Entity type:Individual
Prefix:DR
First Name:MAILA
Middle Name:A
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 56
Mailing Address - Street 2:8059 KEKAHA RD
Mailing Address - City:KEKAHA
Mailing Address - State:HI
Mailing Address - Zip Code:96752-0056
Mailing Address - Country:US
Mailing Address - Phone:808-517-5723
Mailing Address - Fax:918-421-2938
Practice Address - Street 1:8059 KEKAHA RD
Practice Address - Street 2:
Practice Address - City:KEKAHA
Practice Address - State:HI
Practice Address - Zip Code:96752
Practice Address - Country:US
Practice Address - Phone:808-517-5723
Practice Address - Fax:918-421-2938
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-10629208000000X
HIMD10629208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00D0216590OtherHMSA