Provider Demographics
NPI:1033197470
Name:YAMASHITA, DOUGLAS HIROSHI (MD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:HIROSHI
Last Name:YAMASHITA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1276 KINOOLE ST
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-4135
Mailing Address - Country:US
Mailing Address - Phone:808-935-7181
Mailing Address - Fax:808-935-6332
Practice Address - Street 1:1276 KINOOLE ST
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-4135
Practice Address - Country:US
Practice Address - Phone:808-935-7181
Practice Address - Fax:808-935-6332
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-05
Last Update Date:2017-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI5571207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0000BFCVRMedicare ID - Type Unspecified
C98690Medicare UPIN
C98690Medicare UPIN