1194952457 NPI number — MRS. MIRIAM JESSIE SEITZ M.D.

Table of content: DR. KYLE HOVE DC (NPI 1922694033)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194952457 NPI number — MRS. MIRIAM JESSIE SEITZ M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SEITZ
Provider First Name:
MIRIAM
Provider Middle Name:
JESSIE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BENTLEY-TAYLOR
Provider Other First Name:
MIRIAM
Provider Other Middle Name:
JESSIE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1194952457
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/18/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 17460
Provider Second Line Business Mailing Address:
915 N KING ST
Provider Business Mailing Address City Name:
HONOLULU
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96817
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-845-8578
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
915 N KING ST
Provider Second Line Business Practice Location Address:
KALIHI-PALAMA HEALTH CENTER
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96817
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-845-8578
Provider Business Practice Location Address Fax Number:
808-845-7279
Provider Enumeration Date:
06/15/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207VF0040X , with the licence number:  18243 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)