Provider Demographics
NPI:1528137510
Name:FUJIOKA, RUSSELL S (MD)
Entity type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:S
Last Name:FUJIOKA
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 1:95-1249 MEHEULA PKWY
Mailing Address - Street 2:UNIT 187
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-1779
Mailing Address - Country:US
Mailing Address - Phone:808-625-6444
Mailing Address - Fax:808-623-2552
Practice Address - Street 1:95-1249 MEHEULA PKWY
Practice Address - Street 2:UNIT 187
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-1779
Practice Address - Country:US
Practice Address - Phone:808-625-6444
Practice Address - Fax:808-623-2552
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-7908207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000201095OtherHMSA
HI1458444OtherUHA
HI074491Medicaid
HI53830Medicare ID - Type Unspecified
HIF99517Medicare UPIN