Provider Demographics
NPI:1235174962
Name:FUJIYOSHI, CAROL A (MD)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:A
Last Name:FUJIYOSHI
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 1:3-3420 KUHIO HWY STE B
Mailing Address - Street 2:
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766-1098
Mailing Address - Country:US
Mailing Address - Phone:808-245-1511
Mailing Address - Fax:
Practice Address - Street 1:3-3420 KUHIO HWY STE B
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1098
Practice Address - Country:US
Practice Address - Phone:808-245-1511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2011-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000026408207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3092552Medicaid
TNG06214Medicare UPIN
TN3092552Medicare ID - Type UnspecifiedERPG INDIVIDUAL MCR#