Provider Demographics
NPI:1881105286
Name:BRYAN MIH, MD LLC
Entity type:Organization
Organization Name:BRYAN MIH, MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MIH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-941-7744
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-12
Last Update Date:2017-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-13759208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty