Provider Demographics
NPI:1063769537
Name:MEDICUS, INC
Entity type:Organization
Organization Name:MEDICUS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PRISCILLA
Authorized Official - Middle Name:KIM
Authorized Official - Last Name:CODIGA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-282-3760
Mailing Address - Street 1:59-073 KAHAE RD
Mailing Address - Street 2:
Mailing Address - City:HALEIWA
Mailing Address - State:HI
Mailing Address - Zip Code:96712
Mailing Address - Country:US
Mailing Address - Phone:808-282-3760
Mailing Address - Fax:
Practice Address - Street 1:59-073 KAHAE RD
Practice Address - Street 2:
Practice Address - City:HALEIWA
Practice Address - State:HI
Practice Address - Zip Code:96712
Practice Address - Country:US
Practice Address - Phone:808-282-3760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-14
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-16690207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty