Basic Information
| Provider Information | |||||||||
| NPI: | 1619273554 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MHD ENTERPRISES, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 83-5762 MAMALAHOA HWY | ||||||||
| Address2: | |||||||||
| City: | CAPTAIN COOK | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967048306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8083454833 | ||||||||
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| Practice Location | |||||||||
| Address1: | 79-1019 HAUKAPILA ST | ||||||||
| Address2: | |||||||||
| City: | KEALAKEKUA | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967507920 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8083229311 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/09/2011 | ||||||||
| LastUpdateDate: | 02/09/2011 | ||||||||
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| AuthorizedOfficialLastName: | DAGDAG | ||||||||
| AuthorizedOfficialFirstName: | MICHELLE | ||||||||
| AuthorizedOfficialMiddleName: | HUBER | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8083454833 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | MD9886 | HI | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.