Provider Demographics
NPI:1174617823
Name:SIA, MICHAEL HUNG TAI (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:HUNG TAI
Last Name:SIA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1941 PIIMAUNA PLACE
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96821
Mailing Address - Country:US
Mailing Address - Phone:808-377-2367
Mailing Address - Fax:808-377-2367
Practice Address - Street 1:1319 PUNAHOU STREET SUITE 1190
Practice Address - Street 2:KAPIOLANI MEDICAL CENTER FOR WOMEN & CHILDREN
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826
Practice Address - Country:US
Practice Address - Phone:808-945-9955
Practice Address - Fax:808-945-9988
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
HIMD-8789208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI03799301Medicaid
HI0000BDXDRMedicare ID - Type Unspecified
HI03799301Medicaid