Provider Demographics
NPI:1134480965
Name:SHAHWAN, SUHAIR AFIF (DPM)
Entity Type:Individual
Prefix:
First Name:SUHAIR
Middle Name:AFIF
Last Name:SHAHWAN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1329 LUSITANA ST STE 802
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2434
Mailing Address - Country:US
Mailing Address - Phone:509-438-5984
Mailing Address - Fax:
Practice Address - Street 1:1329 LUSITANA ST STE 802
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2434
Practice Address - Country:US
Practice Address - Phone:509-438-5984
Practice Address - Fax:509-438-5984
Is Sole Proprietor?:No
Enumeration Date:2012-06-07
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI201213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery