MEDICARE: NORTH SHORE ORTHOPEDICS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician

General Provider Information

NPI Number	:	1659571461
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH SHORE ORTHOPEDICS INC

Provider Business Mailing Address
First Line	:	30 E LIPOA ST UNIT 4106
Second Line	:
City	:	KIHEI
State	:	HI
Zip	:	96753-5821
Country	:	US
Telephone Number	:	808-242-0001
Fax Number	:

Provider Business Practice Location Address
First Line	:	30 E LIPOA ST UNIT 4106
Second Line	:
City	:	KIHEI
State	:	HI
Zip	:	96753-5821
Country	:	US
Telephone Number	:	808-242-0001
Fax Number	:	808-244-6746

Authorized Official
Title or Position	:	OWNER
Name	:	CHARLES SOMA
Credential	:	MD
Telephone Number	:	808-283-6768

Provider Enumeration Date	:	07/19/2007
Last Update Date	:	12/12/2025

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Directions to “NORTH SHORE ORTHOPEDICS INC ” Practice Location

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