Provider Demographics
NPI:1558402404
Name:EHARA, SHIGERU (MD)
Entity Type:Individual
Prefix:DR
First Name:SHIGERU
Middle Name:
Last Name:EHARA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:191 UCHIMARU
Mailing Address - Street 2:IWATE MEDICAL UNIVERSITY, RADIOLOGY
Mailing Address - City:MORIOKA
Mailing Address - State:IWATE
Mailing Address - Zip Code:0208505
Mailing Address - Country:JP
Mailing Address - Phone:8119-651-5111
Mailing Address - Fax:8119-651-7071
Practice Address - Street 1:191 UCHIMARU
Practice Address - Street 2:IWATE MEDICAL UNIVERSITY, RADIOLOGY
Practice Address - City:MORIOKA
Practice Address - State:IWATE
Practice Address - Zip Code:0208505
Practice Address - Country:JP
Practice Address - Phone:8119-651-5111
Practice Address - Fax:8119-651-7071
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA580152085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology