Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | PO-118 | HI |
N | 222Z00000X | Podiatrist | PO-118 | HI |
Y | 213ES0103X | Foot & Ankle Surgery | PO-118 | HI |
NPI | 1063516227 |
---|---|
Provider Name | Brian T. Sugai |
First Address | Hilo, HI 96720-4261 |
Second Address | Hilo, HI 96720-4261 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2006 |
Last Update Date | 28/07/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03103001 | (05) | HI |
040419 | (02) |