Provider Demographics
NPI:1497862783
Name:URAMOTO, JENNY MN (MD)
Entity type:Individual
Prefix:DR
First Name:JENNY
Middle Name:MN
Last Name:URAMOTO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1099 ALAKEA ST
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-4511
Mailing Address - Country:US
Mailing Address - Phone:808-547-4600
Mailing Address - Fax:808-547-4559
Practice Address - Street 1:377 KEAHOLE ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96825-3405
Practice Address - Country:US
Practice Address - Phone:808-396-6675
Practice Address - Fax:808-395-2104
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD7339207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI047057Medicaid
HIF56880Medicare UPIN
HI100484Medicare ID - Type Unspecified