Healthcare Provider Details

I. General information

NPI: 1417593831
Provider Name (Legal Business Name): CHAD LM AHIA MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2019
Last Update Date: 05/19/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28-1680 OLD MAMALAHOA HWY UNIT A
HONOMU HI
96728
US

IV. Provider business mailing address

PO BOX 352
HONOMU HI
96728-0352
US

V. Phone/Fax

Practice location:
  • Phone: 808-238-0232
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD-23044
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: