Provider Demographics
NPI:1174627897
Name:TAMURA, RAYMOND (MD)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:
Last Name:TAMURA
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 1:1414 ALEXANDER ST
Mailing Address - Street 2:#204
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96822
Mailing Address - Country:US
Mailing Address - Phone:808-946-2523
Mailing Address - Fax:
Practice Address - Street 1:90 NAKOLO PL
Practice Address - Street 2:#6
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-1860
Practice Address - Country:US
Practice Address - Phone:808-836-1644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1074174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIA0589-0OtherHMSA
HIA0589-0OtherHMSA
HI0000BBFVNMedicare ID - Type Unspecified