Individual
DR. JENNIFER MAEDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1234 KILAUEA AVE, HILO, HI 96720-4206
(808) 935-5228
(808) 969-9117
Mailing address
1234 KILAUEA AVE, HILO, HI 96720-4282
(808) 935-5228
(808) 969-9117
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
576
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
253237
HMSA PROVIDER NUMBER
HI
05
—
574170-01
—
HI
01
—
7786656
UHA MEDICAL
HI
01
—
778665620
UHA VISION
HI
01
—
H100356
HAWAII MEDICARE
HI
Enumeration date
11/01/2006
Last updated
05/21/2018
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