MEDICARE: NOBUYUKI MIKI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MD7592	HI

General Provider Information

NPI Number	:	1780721290
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NOBUYUKI MIKI M.D.

Provider Business Mailing Address
First Line	:	405 N KUAKINI ST
Second Line	:	STE 1004
City	:	HONOLULU
State	:	HI
Zip	:	96817-6301
Country	:	US
Telephone Number	:	808-521-5220
Fax Number	:	808-536-0320

Provider Business Practice Location Address
First Line	:	405 N KUAKINI ST STE 1004
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96817-6301
Country	:	US
Telephone Number	:	808-521-5220
Fax Number	:	808-441-5588

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2007
Last Update Date	:	01/24/2022

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