MEDICARE: DR. MYRNA S UYTINGCO 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	MD-13833	HI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497790281
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MYRNA S UYTINGCO M.D.

Provider Business Mailing Address
First Line	:	91-2135 FORT WEAVER RD STE 150
Second Line	:
City	:	EWA BEACH
State	:	HI
Zip	:	96706-1929
Country	:	US
Telephone Number	:	808-691-3150
Fax Number	:

Provider Business Practice Location Address
First Line	:	91-2135 FORT WEAVER RD STE 150
Second Line	:
City	:	EWA BEACH
State	:	HI
Zip	:	96706-1929
Country	:	US
Telephone Number	:	808-691-3150
Fax Number	:

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

Provider Enumeration Date	:	06/17/2006
Last Update Date	:	08/04/2020

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