Provider Demographics
NPI:1396793501
Name:FUJITA, JON SHINICHI (MD)
Entity type:Individual
Prefix:DR
First Name:JON
Middle Name:SHINICHI
Last Name:FUJITA
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 1:94-216 FARRINGTON HWY STE 322
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-1923
Mailing Address - Country:US
Mailing Address - Phone:808-676-5629
Mailing Address - Fax:808-676-5736
Practice Address - Street 1:94-216 FARRINGTON HWY STE 322
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-1923
Practice Address - Country:US
Practice Address - Phone:808-676-5629
Practice Address - Fax:808-676-5736
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD6060207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI52520601Medicaid
HI07768OtherHMSA
HI07768OtherHMSA
E58525Medicare UPIN