1063427441 NPI number — DR. JAMIL S SULIEMAN M.D.

Table of content: DR. JAMIL S SULIEMAN M.D. (NPI 1063427441)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063427441 NPI number — DR. JAMIL S SULIEMAN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SULIEMAN
Provider First Name:
JAMIL
Provider Middle Name:
S
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1063427441
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/16/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
46-001 KAMEHAMEHA HWY
Provider Second Line Business Mailing Address:
SUITE 314
Provider Business Mailing Address City Name:
KANEOHE
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96744-3711
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-234-0033
Provider Business Mailing Address Fax Number:
808-234-0055

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
46-001 KAMEHAMEHA HWY
Provider Second Line Business Practice Location Address:
SUITE 314
Provider Business Practice Location Address City Name:
KANEOHE
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96744-3711
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-234-0033
Provider Business Practice Location Address Fax Number:
808-234-0055
Provider Enumeration Date:
07/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RP1001X , with the licence number:  MD7571 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207RS0012X , with the licence number: MD7571 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 07037703 , issued by the state of ( HI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 07037705 , issued by the state of ( HI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3196466 . This is a "UHA" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 680542603 . This is a "TID" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 00E0091420 . This is a "HMSA" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 00F0091428 . This is a "HMSA" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".




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