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NPI Code Detail

MEDICARE: SHUNSUKE OHORI

MEDICARE: SHUNSUKE OHORI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1851708457
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHUNSUKE OHORI
Provider Business Mailing Address
First Line : 5128 20 1/2 AVENUE LN NW
Second Line :
City : ROCHESTER
State : MN
Zip : 55901-2060
Country : US
Telephone Number : 857-265-8980
Fax Number :
Provider Business Practice Location Address
First Line : 5128 20 1/2 AVENUE LN NW
Second Line :
City : ROCHESTER
State : MN
Zip : 55901-2060
Country : US
Telephone Number : 857-265-8980
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2014
Last Update Date : 07/15/2014

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Directions to “ SHUNSUKE OHORI ” Practice Location

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