Individual
MARTA L DERIEG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
76-6225 KUAKINI HWY, STE C101, KAILUA KONA, HI 96740-3212
(808) 329-7067
(808) 329-2404
Mailing address
76-6225 KUAKINI HWY, STE C101, KAILUA KONA, HI 96740-3212
(808) 329-7067
(808) 329-2404
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD10708
HI
2080A0000X
Pediatric Adolescent Medicine Physician
MD10708
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
49585501
—
HI
Enumeration date
04/19/2006
Last updated
12/03/2013
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