Provider Demographics
NPI:1720172216
Name:MIH, BRYAN D (MD)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:D
Last Name:MIH
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 1:1319 PUNAHOU ST STE 1020
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-1077
Mailing Address - Country:US
Mailing Address - Phone:808-941-7744
Mailing Address - Fax:808-941-7746
Practice Address - Street 1:1319 PUNAHOU ST STE 1020
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-1077
Practice Address - Country:US
Practice Address - Phone:808-941-7744
Practice Address - Fax:808-941-7746
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2017-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-13759208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics