Individual
GREGG ATSUSHI SHIMOMURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
99 128 AIEA HEIGHTS DRIVE, SUITE 504, AIEA, HI 96701-3938
(808) 487-2497
(808) 487-2494
Mailing address
99 128 AIEA HEIGHTS DRIVE, SUITE 504, AIEA, HI 96701-3938
(808) 487-2497
(808) 487-2494
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD6215
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05906901
—
HI
01
—
078493
HAWAII MEDICAL SERVICE AS
HI
Enumeration date
04/02/2007
Last updated
07/08/2007
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