Provider Demographics
NPI:1255313995
Name:WAGNILD-NOJIMA, DEBBIE KIKUKO (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBBIE
Middle Name:KIKUKO
Last Name:WAGNILD-NOJIMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DEBBIE
Other - Middle Name:KIKUKO
Other - Last Name:NOJIMA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:480 CENTRAL AVE BLDG 6905
Mailing Address - Street 2:
Mailing Address - City:JBPHH
Mailing Address - State:HI
Mailing Address - Zip Code:96860-4908
Mailing Address - Country:US
Mailing Address - Phone:808-257-3365
Mailing Address - Fax:
Practice Address - Street 1:480 CENTRAL AVE BLDG 6905
Practice Address - Street 2:
Practice Address - City:JBPHH
Practice Address - State:HI
Practice Address - Zip Code:96860-4908
Practice Address - Country:US
Practice Address - Phone:808-257-3365
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD10238208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics