Provider Demographics
NPI:1649570870
Name:ALAN T. SUYAMA, MD, INC.
Entity Type:Organization
Organization Name:ALAN T. SUYAMA, MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:T
Authorized Official - Last Name:SUYAMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-536-3402
Mailing Address - Street 1:1050 BISHOP ST # 535
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-4210
Mailing Address - Country:US
Mailing Address - Phone:808-536-3402
Mailing Address - Fax:808-833-2209
Practice Address - Street 1:1301 PUNCHBOWL ST.
Practice Address - Street 2:THE QUEEN'S MEDICAL CENTER
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813
Practice Address - Country:US
Practice Address - Phone:808-538-9011
Practice Address - Fax:808-585-5195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-21
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-4192207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI01504707Medicaid
HIC98961Medicare UPIN
0000BDKTBMedicare PIN