Provider Demographics
NPI:1558471342
Name:MAGLIULO, ANTHONY FRANK (MD)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:FRANK
Last Name:MAGLIULO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:642 ULUKAHIKI ST
Mailing Address - Street 2:STE 303
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-4439
Mailing Address - Country:US
Mailing Address - Phone:808-262-0606
Mailing Address - Fax:808-262-1889
Practice Address - Street 1:642 ULUKAHIKI ST
Practice Address - Street 2:STE 303
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-4439
Practice Address - Country:US
Practice Address - Phone:808-262-0606
Practice Address - Fax:808-262-1889
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI5009207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIMD500902OtherMDX
0000BDPDZOtherKAISER ADDED CHOICE
HI00E002313-4OtherBLUE CARD HAWAII
HI00E002313-4OtherQUEST HMSA
HI020921Medicaid
99-0280579OtherOTHER COMMERCIAL
HI00E002313-4OtherHMSA
00E002313-4OtherFEP
HI02092101OtherQUEST ALOHA CARE
0000BDPDZOtherKAISER ADDED CHOICE
D43470Medicare UPIN