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General NPI Number Information
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NPI Number | 1053035584
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Entity Type | Organization
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Legal Business Name | ERI SHIMIZU M.D. LLC
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Dates
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Enumeration Date | 09/28/2022
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Last Update Date | 09/29/2022
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Provider Practice Location Address
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Address Line | 270 HOOKAHI ST STE 305
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City | WAILUKU
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State | HI
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Zip | 96793-1466
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Country | US
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Telephone | 808-435-6262
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Fax | 877-795-4940
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Provider Business Mailing Address
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Address Line | 115 KAMAIKI CIR
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City | KAHULUI
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State | HI
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Zip | 96732-3154
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Country | US
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Telephone | 808-500-8420
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ERI SHIMIZU
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Credential | MD
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Telephone | 808-500-8420
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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