Organization
ORCHID ISLE NEUROLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NORIFUSA JOHN ANEGAWA M.D., PH.D. (OWNER)
(808) 885-9308
Entity
Organization
Contact information
Practice address
67-1123 MAMALAHOA HWY, SUITE 110, KAMUELA, HI 96743-8451
(808) 885-9308
(808) 885-9310
Mailing address
PO BOX 437319, KAMUELA, HI 96743-7143
(808) 885-9308
(808) 885-9310
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
13015
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000252148
HMSA ID
HI
05
—
100371
—
HI
01
—
DD5219
RAILROAD MEDICARE GROUP
HI
Enumeration date
11/17/2006
Last updated
08/22/2020
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