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General NPI Number Information
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NPI Number | 1427038561
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Entity Type | Individual
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Provider Name | NORMAN T IKEMOTO MD
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Gender | Male
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Dates
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Enumeration Date | 01/17/2006
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Last Update Date | 07/12/2007
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Provider Practice Location Address
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Address Line | 640 ULUKAHIKI ST
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City | KAILUA
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State | HI
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Zip | 96734
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Country | US
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Telephone | 808-263-5166
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Fax | 808-263-5167
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Provider Business Mailing Address
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Address Line | 941 KAMEHAMEHA HWY STE 208
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City | PEARL CITY
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State | HI
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Zip | 96782-2516
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Country | US
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Telephone | 808-454-5200
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Fax | 808-454-5201
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 2815
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License Number State | HI
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