Provider Demographics
NPI:1033207428
Name:TS'KAMURA, SUMIKO (MD)
Entity Type:Individual
Prefix:
First Name:SUMIKO
Middle Name:
Last Name:TS'KAMURA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:SUMIKO
Other - Middle Name:TS'KAMURA
Other - Last Name:HAMILTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:419 LEE ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-8658
Mailing Address - Country:US
Mailing Address - Phone:252-355-5396
Mailing Address - Fax:252-355-6171
Practice Address - Street 1:503 BOWMAN GRAY DR STE A
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-7286
Practice Address - Country:US
Practice Address - Phone:252-830-2728
Practice Address - Fax:252-752-8288
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18775207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C80737Medicare UPIN
201537Medicare ID - Type Unspecified