Provider Demographics
NPI:1912958661
Name:SHIKUMA, CRAIG YOSHIHIRO (MD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:YOSHIHIRO
Last Name:SHIKUMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:82 PUUHONU PL
Mailing Address - Street 2:SUITE 207
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-2010
Mailing Address - Country:US
Mailing Address - Phone:808-935-5522
Mailing Address - Fax:808-961-5058
Practice Address - Street 1:82 PUUHONU PL
Practice Address - Street 2:SUITE 207
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2010
Practice Address - Country:US
Practice Address - Phone:808-935-5522
Practice Address - Fax:808-961-5058
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI3967207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0051896OtherHMSA PROVIDER NUMBER
HI045682-01Medicaid
HIC98619Medicare UPIN
HI045682-01Medicaid