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Individual

AMANDA MARN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
210 IMI KALA ST STE 209, WAILUKU, HI 96793-1274
(808) 673-5778
Mailing address
210 IMI KALA ST STE 209, WAILUKU, HI 96793-1274
(808) 673-5778

Taxonomy

Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
MD-20631
HI
207RC0000X
Cardiovascular Disease Physician
Primary
85491-20
WI
207RC0000X
Cardiovascular Disease Physician
MD-20631
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1790006286
WI
Enumeration date
06/18/2010
Last updated
04/08/2025
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