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General NPI Number Information
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NPI Number | 1689875304
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Entity Type | Individual
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Provider Name | MALIA ANNE LAM SHIMOKAWA M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 08/29/2012
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Provider Practice Location Address
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Address Line | UNIT 31403 BOX 13 USAHC-VICENZA, DEPARTMENT OF PEDIATRICS
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City | APO
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State | AE
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Zip | 09630-1403
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Country | US
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Telephone | 314-636-9020
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Fax |
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Provider Business Mailing Address
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Address Line | UNIT 31403 BOX 13 USAHC-VICENZA, DEPARTMENT OF PEDIATRICS
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City | APO
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State | AE
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Zip | 09630-1403
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Country | US
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Telephone |
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Fax |
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD-14380
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License Number State | HI
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