Provider Demographics
NPI:1013911734
Name:SUGIHARA, STUART (MD)
Entity type:Individual
Prefix:DR
First Name:STUART
Middle Name:
Last Name:SUGIHARA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 N KUAKINI ST
Mailing Address - Street 2:STE 502
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-2361
Mailing Address - Country:US
Mailing Address - Phone:808-531-9753
Mailing Address - Fax:808-531-5408
Practice Address - Street 1:321 N KUAKINI ST
Practice Address - Street 2:STE 502
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-2361
Practice Address - Country:US
Practice Address - Phone:808-531-9753
Practice Address - Fax:808-531-5408
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-09
Last Update Date:2007-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI3866207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI4967-6OtherHMSA
HI04448301Medicaid
HIH0000BDHFQMedicare ID - Type Unspecified
HI04448301Medicaid