Provider Demographics
NPI:1548227861
Name:NAKAMURA, HARVEY T (MD)
Entity Type:Individual
Prefix:DR
First Name:HARVEY
Middle Name:T
Last Name:NAKAMURA
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 1:688 KINOOLE ST
Mailing Address - Street 2:STE 103
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720
Mailing Address - Country:US
Mailing Address - Phone:808-935-1825
Mailing Address - Fax:808-935-5362
Practice Address - Street 1:670 PONAHAWAI ST
Practice Address - Street 2:#110
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720
Practice Address - Country:US
Practice Address - Phone:808-933-2540
Practice Address - Fax:808-935-5207
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD37532085N0904X, 2085R0202X, 2085R0204X, 2085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI04551701Medicaid
HI01WCCBC710Medicare ID - Type Unspecified
C97538Medicare UPIN