Provider Demographics
NPI:1679812531
Name:SHIELDS, RYAN YOSHIMURA (MD)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:YOSHIMURA
Last Name:SHIELDS
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 1:1380 LUSITANA ST STE 1004
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2461
Mailing Address - Country:US
Mailing Address - Phone:808-686-4690
Mailing Address - Fax:808-686-2127
Practice Address - Street 1:1380 LUSITANA ST STE 1004
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2461
Practice Address - Country:US
Practice Address - Phone:808-686-4690
Practice Address - Fax:808-686-2127
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-12
Last Update Date:2022-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2020-0672207V00000X
HIMD-22923207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology