Provider Demographics
NPI:1639285059
Name:UKISHIMA, CHI (MD)
Entity Type:Individual
Prefix:
First Name:CHI
Middle Name:
Last Name:UKISHIMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2402 MARILYN DR
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-4219
Mailing Address - Country:US
Mailing Address - Phone:402-850-8388
Mailing Address - Fax:
Practice Address - Street 1:984455 NEBRASKA MEDICAL CENTER OMAHA NE 68198 4455
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-4455
Practice Address - Country:US
Practice Address - Phone:402-559-4081
Practice Address - Fax:402-559-7372
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IAR7899207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine