Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | MD-5527 | HI |
Y | 207QS0010X | Family Doctor - Sports Medicine | MD-5527 | HI |
NPI | 1174624027 |
---|---|
Provider Name | Dr. Guy M. Sugino |
First Address | Wailuku, HI 96793-2416 |
Second Address | Wailuku, HI 96793-2416 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2006 |
Last Update Date | 19/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
051996-03 | (05) | HI |
E64701 | (02) | HI |