Provider Demographics
NPI:1124033543
Name:NAKAMURA, STEVE T (PT)
Entity Type:Individual
Prefix:
First Name:STEVE
Middle Name:T
Last Name:NAKAMURA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4381 KUKUI GROVE ST
Mailing Address - Street 2:STE 3
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766
Mailing Address - Country:US
Mailing Address - Phone:808-246-0144
Mailing Address - Fax:808-245-5148
Practice Address - Street 1:4381 KUKUI GROVE ST
Practice Address - Street 2:STE 3
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766
Practice Address - Country:US
Practice Address - Phone:808-246-0144
Practice Address - Fax:808-245-5148
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI50131303Medicaid
HI50131303Medicaid