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NPI 1811963994

NPI 1811963994 : GLEN H SUGIYAMA MD : HONOLULU, HI

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General NPI Number Information
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    NPI Number           |    1811963994
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    Entity Type          |    Individual 
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    Provider Name        |    GLEN H SUGIYAMA MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    02/27/2006
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    Last Update Date     |    01/04/2011
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Provider Practice Location Address
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    Address Line         |    1329 LUSITANA ST SUITE 203
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    City                 |    HONOLULU
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    State                |    HI
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    Zip                  |    96813
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    Country              |    US
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    Telephone            |    808-538-3021
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    Fax                  |    808-533-6397
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Provider Business Mailing Address
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    Address Line         |    820 MILIANI STREET SUITE 702A
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    City                 |    HONOLULU
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    State                |    HI
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    Zip                  |    96813
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    Country              |    US
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    Telephone            |    808-523-9363
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    Fax                  |    808-523-9418
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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        |    207R00000X
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    Taxonomy Name        |    Internal Medicine Physician
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    License Number       |    MD 4337
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    License Number State |    HI
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