Healthcare Provider Details

I. General information

NPI: 1902812704
Provider Name (Legal Business Name): TAMARA LIEN BIEGA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 05/04/2022
Certification Date: 04/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 JARRETT WHITE RD
TRIPLER ARMY MEDICAL CENTER HI
96859-5001
US

IV. Provider business mailing address

1087 IKENA CIR
HONOLULU HI
96821-2557
US

V. Phone/Fax

Practice location:
  • Phone: 808-433-6039
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number11286
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License Number11286
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: