Provider Demographics
NPI:1699985721
Name:MAUI ANESTHESIA PRACTICE, INC.
Entity type:Organization
Organization Name:MAUI ANESTHESIA PRACTICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TESHA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:NEWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-280-6301
Mailing Address - Street 1:PO BOX 392
Mailing Address - Street 2:
Mailing Address - City:KULA
Mailing Address - State:HI
Mailing Address - Zip Code:96790-0392
Mailing Address - Country:US
Mailing Address - Phone:808-878-1358
Mailing Address - Fax:
Practice Address - Street 1:239 HOOHANA ST
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-2452
Practice Address - Country:US
Practice Address - Phone:808-893-0578
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-13055207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI566557-01Medicaid
HIH100876Medicare ID - Type Unspecified
HIH97532Medicare UPIN