Provider Demographics
NPI:1538160866
Name:SHIKUMA, NEAL J (MD, FACC)
Entity type:Individual
Prefix:DR
First Name:NEAL
Middle Name:J
Last Name:SHIKUMA
Suffix:
Gender:M
Credentials:MD, FACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 LILIHA ST
Mailing Address - Street 2:SUITE 12
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-3522
Mailing Address - Country:US
Mailing Address - Phone:808-540-1530
Mailing Address - Fax:808-356-0424
Practice Address - Street 1:65-1230 MAMALAHOA HWY
Practice Address - Street 2:
Practice Address - City:KAMUELA
Practice Address - State:HI
Practice Address - Zip Code:96743-8318
Practice Address - Country:US
Practice Address - Phone:808-887-6410
Practice Address - Fax:808-887-6429
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-4389207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI01103201Medicaid
HI00Q0011521OtherBLUE CROSS/BLUE SHIELD
HI00R0011529OtherBLUE CROSS/BLUE SHIELD
HI00T0011522OtherBLUE CROSS/BLUE SHIELD
HI00R0011529OtherHMSA
HI01103203Medicaid
IDP00075664OtherRR MEDICARE
HI00110322OtherALOHA CARE
HI00Q0011521OtherHMSA
HI00T0011522OtherHMSA
HIMD-4389OtherQUEEN'S ISLAND CARE
HI01103207Medicaid
HI00Q0011521OtherBLUE CROSS/BLUE SHIELD
HIH52321Medicare PIN