Provider Demographics
NPI:1447378013
Name:MARTIN, MARIA GLORIA (DAC)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:GLORIA
Last Name:MARTIN
Suffix:
Gender:F
Credentials:DAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6508 HAWAII KAI DR
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96825-1112
Mailing Address - Country:US
Mailing Address - Phone:808-744-7568
Mailing Address - Fax:877-860-8571
Practice Address - Street 1:6508 HAWAII KAI DR
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96825-1112
Practice Address - Country:US
Practice Address - Phone:808-744-7568
Practice Address - Fax:877-860-8571
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI200171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist