Provider Demographics
NPI:1568782605
Name:SHIKUMA LEE, KELSEY MICHIKO (MD)
Entity Type:Individual
Prefix:DR
First Name:KELSEY
Middle Name:MICHIKO
Last Name:SHIKUMA LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KELSEY
Other - Middle Name:MICHIKO
Other - Last Name:SHIKUMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1356 LUSITANA ST
Mailing Address - Street 2:7TH FLOOR
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2409
Mailing Address - Country:US
Mailing Address - Phone:808-536-3773
Mailing Address - Fax:
Practice Address - Street 1:1356 LUSITANA ST
Practice Address - Street 2:7TH FLOOR
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2409
Practice Address - Country:US
Practice Address - Phone:808-536-3773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-10
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA11290207RE0101X, 207R00000X
HIMD17573207RE0101X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine