Provider Demographics
NPI:1063678456
Name:SHIMIZU, ERI HARUKO (MD)
Entity Type:Individual
Prefix:
First Name:ERI
Middle Name:HARUKO
Last Name:SHIMIZU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 KAMAIKI CIRCLE
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732
Mailing Address - Country:US
Mailing Address - Phone:808-500-8420
Mailing Address - Fax:877-795-4940
Practice Address - Street 1:270 HOOKAHI STREET
Practice Address - Street 2:SUITE 305
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793
Practice Address - Country:US
Practice Address - Phone:808-435-6262
Practice Address - Fax:877-795-4940
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-05
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI15871207R00000X, 208D00000X
HIMD-15871208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist