Provider Demographics
NPI:1952419731
Name:VALIN, MYRNA SADDAM (MD)
Entity Type:Individual
Prefix:
First Name:MYRNA
Middle Name:SADDAM
Last Name:VALIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MYRNA
Other - Middle Name:S
Other - Last Name:VALIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2119 N KING ST
Mailing Address - Street 2:102
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-4550
Mailing Address - Country:US
Mailing Address - Phone:808-841-3641
Mailing Address - Fax:808-841-3667
Practice Address - Street 1:2119 N KING ST
Practice Address - Street 2:102
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-4550
Practice Address - Country:US
Practice Address - Phone:808-841-3641
Practice Address - Fax:808-841-3667
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI4733208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics