Provider Demographics
NPI:1801997895
Name:TERAMOTO, RON ISAMU (MD)
Entity type:Individual
Prefix:
First Name:RON
Middle Name:ISAMU
Last Name:TERAMOTO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:99-128 AIEA HEIGHTS DR
Mailing Address - Street 2:STE 303
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-3932
Mailing Address - Country:US
Mailing Address - Phone:808-487-3685
Mailing Address - Fax:808-487-3012
Practice Address - Street 1:99-128 AIEA HEIGHTS DR
Practice Address - Street 2:STE 303
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-3932
Practice Address - Country:US
Practice Address - Phone:808-487-3685
Practice Address - Fax:808-487-3012
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2018-10-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
HIMD 6935207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI07034401Medicaid
H0000BDTHBMedicare ID - Type Unspecified
HI07034401Medicaid