Healthcare Provider Details

I. General information

NPI: 1063516227
Provider Name (Legal Business Name): BRIAN T. SUGAI DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2006
Last Update Date: 01/26/2023
Certification Date: 01/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 AUPUNI ST STE 238
HILO HI
96720-4261
US

IV. Provider business mailing address

101 AUPUNI ST STE 238
HILO HI
96720-4261
US

V. Phone/Fax

Practice location:
  • Phone: 808-935-5597
  • Fax: 808-935-7904
Mailing address:
  • Phone: 808-935-5597
  • Fax: 808-935-7904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO-118
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPO-118
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: