Provider Demographics
NPI:1851708457
Name:OHORI, SHUNSUKE
Entity Type:Individual
Prefix:
First Name:SHUNSUKE
Middle Name:
Last Name:OHORI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5128 20 1/2 AVENUE LN NW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-2060
Mailing Address - Country:US
Mailing Address - Phone:857-265-8980
Mailing Address - Fax:
Practice Address - Street 1:5128 20 1/2 AVENUE LN NW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-2060
Practice Address - Country:US
Practice Address - Phone:857-265-8980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-15
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program