Provider Demographics
NPI:1831290998
Name:MINAMI, SHARON A (MD)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:A
Last Name:MINAMI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1329 LUSITANA ST
Mailing Address - Street 2:SUITE 109
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2429
Mailing Address - Country:US
Mailing Address - Phone:808-536-9888
Mailing Address - Fax:
Practice Address - Street 1:1329 LUSITANA ST
Practice Address - Street 2:SUITE 109
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2429
Practice Address - Country:US
Practice Address - Phone:808-536-9888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-8381207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000082149OtherHMSA BILLING NUMBER
HI061830-02Medicaid
HI0000082149OtherHMSA BILLING NUMBER
HI061830-02Medicaid
HIH103690Medicare PIN
HIF28020Medicare UPIN
WAG8883264Medicare PIN