Provider Demographics
NPI:1447327887
Name:PI, MICHAEL PC (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:PC
Last Name:PI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 656
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-0656
Mailing Address - Country:US
Mailing Address - Phone:808-247-1294
Mailing Address - Fax:808-235-6280
Practice Address - Street 1:1319 PUNAHOU ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-1001
Practice Address - Country:US
Practice Address - Phone:808-247-1294
Practice Address - Fax:808-235-6280
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD9055174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIA20132-5OtherHMSA
HI074623-02Medicaid
HI074623-02Medicaid