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Individual

STEPHEN KEN MIYASATO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
99-128 AIEA HTS DR, STE 105, AIEA, HI 96701-3916
(808) 487-9922
(808) 483-6841
Mailing address
99-128 AIEA HTS DR, STE 105, AIEA, HI 96701-3916
(808) 487-9922
(808) 483-6841

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD 4730
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00A001360 5
HMSA
HI
01
192075101
HMA
05
990259803
HI
Enumeration date
11/22/2005
Last updated
10/20/2010
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