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Organization

RUSSELL T. OGAWA, MD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RUSSELL T. OGAWA M.D. (PRESIDENT)
(808) 448-8441
Entity
Organization

Contact information

Practice address
99-128 AIEA HEIGHTS DRIVE, SUITE 211, AIEA, HI 96701-3972
(808) 488-8441
(808) 200-3790
Mailing address
99-128 AIEA HEIGHTS DRIVE, SUITE 211, AIEA, HI 96701-3972
(808) 488-8441
(808) 200-3790

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000216242
HMSA
HI
05
25236101
HI
Enumeration date
01/10/2020
Last updated
01/10/2020
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