Provider Demographics
NPI:1255742631
Name:FUJII, MIKA JULIA (MD)
Entity type:Individual
Prefix:
First Name:MIKA
Middle Name:JULIA
Last Name:FUJII
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 1:2016 S ELIZABETH ST
Mailing Address - Street 2:
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46902-2430
Mailing Address - Country:US
Mailing Address - Phone:765-450-4776
Mailing Address - Fax:765-450-6097
Practice Address - Street 1:2016 S ELIZABETH ST
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46902-2430
Practice Address - Country:US
Practice Address - Phone:765-450-4776
Practice Address - Fax:765-450-6097
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-19
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01045921A171100000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty