Healthcare Provider Details

I. General information

NPI: 1821099144
Provider Name (Legal Business Name): HAWAII CARDIOLOGY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

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 SUITE D10
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: 808-356-0424
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: DR. NEAL J SHIKUMA
Title or Position: PRESIDENT
Credential: M.D., FACC
Phone: 808-887-6410