Provider Demographics
NPI:1881294205
Name:JDMD PARTNERS, LLP
Entity type:Organization
Organization Name:JDMD PARTNERS, LLP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MICAH
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVID
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:808-379-0428
Mailing Address - Street 1:928 NUUANU AVENUE
Mailing Address - Street 2:LOWER-LEVEL SUITE 104
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817
Mailing Address - Country:US
Mailing Address - Phone:808-379-0428
Mailing Address - Fax:808-600-3759
Practice Address - Street 1:928 NUUANU AVE STE 104
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-5193
Practice Address - Country:US
Practice Address - Phone:808-379-0428
Practice Address - Fax:808-320-6647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-26
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
1669961322OtherNPI NUMBER