Provider Demographics
NPI:1568533065
Name:NISHI, STEVEN M (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:M
Last Name:NISHI
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 1:915 N KING ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-4544
Mailing Address - Country:US
Mailing Address - Phone:808-848-1438
Mailing Address - Fax:808-841-7270
Practice Address - Street 1:915 N KING ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-4544
Practice Address - Country:US
Practice Address - Phone:808-848-1438
Practice Address - Fax:808-841-7270
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-8971207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F92515Medicare UPIN
H54761Medicare ID - Type Unspecified