Organization
BRIDGE MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIA CARSON MD (PHYSICIAN/OWNER)
(808) 573-7555
Entity
Organization
Contact information
Practice address
1120A MAKAWAO AVE, MAKAWAO, HI 96768-9448
(808) 573-7555
Mailing address
1120A MAKAWAO AVE, MAKAWAO, HI 96768-9448
(808) 573-7555
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
13323
HI
Other
Enumeration date
07/28/2010
Last updated
07/28/2010
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