Provider Demographics
NPI:1194887067
Name:NAKAMURA, DAVID Y (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:Y
Last Name:NAKAMURA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:670 PONAHAWAI ST
Mailing Address - Street 2:STE 216 HILO FAMILY MEDICINE
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-2660
Mailing Address - Country:US
Mailing Address - Phone:808-934-8989
Mailing Address - Fax:808-934-8990
Practice Address - Street 1:670 PONAHAWAI ST
Practice Address - Street 2:STE 216 HILO FAMILY MEDICINE
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2660
Practice Address - Country:US
Practice Address - Phone:808-934-8989
Practice Address - Fax:808-934-8990
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HIH10347207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0000216192OtherHI MEDICAL SVC ASSOC
HI252350Medicaid
H55640OtherNORIDIAN MEDICARE PTAN
G72243Medicare UPIN