Basic Information
| Provider Information | |||||||||
| NPI: | 1407844905 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MEILY | ||||||||
| FirstName: | MARY IRIS | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4300 WAIALAE AVE | ||||||||
| Address2: | |||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968165761 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8087326259 | ||||||||
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| Practice Location | |||||||||
| Address1: | NAVAL MEDICAL CLINIC | ||||||||
| Address2: | 480 CENTRAL AVENUE | ||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 96860 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8084731880 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/10/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 8876 | HI | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.