Provider Demographics
NPI:1144759507
Name:FIROUZBAKHT, SHARAREH (MD)
Entity type:Individual
Prefix:
First Name:SHARAREH
Middle Name:
Last Name:FIROUZBAKHT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75-5608 HIENALOLI RD UNIT 51
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-8819
Mailing Address - Country:US
Mailing Address - Phone:832-428-8624
Mailing Address - Fax:
Practice Address - Street 1:75-5914 MAMALAHOA HWY
Practice Address - Street 2:
Practice Address - City:HOLUALOA
Practice Address - State:HI
Practice Address - Zip Code:96725-9998
Practice Address - Country:US
Practice Address - Phone:832-428-8624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-08
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI7272207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology