Healthcare Provider Details

I. General information

NPI: 1538160866
Provider Name (Legal Business Name): NEAL J SHIKUMA M.D., FACC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 12/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65-1230 MAMALAHOA HWY
KAMUELA HI
96743-8318
US

IV. Provider business mailing address

1425 LILIHA ST SUITE 12
HONOLULU HI
96817-3522
US

V. Phone/Fax

Practice location:
  • Phone: 808-887-6410
  • Fax: 808-887-6429
Mailing address:
  • Phone: 808-540-1530
  • Fax: 808-356-0424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD-4389
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: