Provider Demographics
NPI:1841373420
Name:HARMS, MARTINA ANGIULO (PA-C)
Entity type:Individual
Prefix:MRS
First Name:MARTINA
Middle Name:ANGIULO
Last Name:HARMS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MARTINA
Other - Middle Name:
Other - Last Name:ANGIULO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:160 ALALA RD
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-3125
Mailing Address - Country:US
Mailing Address - Phone:202-486-8462
Mailing Address - Fax:
Practice Address - Street 1:900 FORT STREET MALL STE 810
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-3707
Practice Address - Country:US
Practice Address - Phone:808-523-5483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAMD-462363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant