Provider Demographics
NPI:1043032642
Name:DATE, HIROSHI (MD)
Entity type:Individual
Prefix:
First Name:HIROSHI
Middle Name:
Last Name:DATE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1 HIGASHIDA-CHO, JODOJI, SAKYO-KU
Mailing Address - Street 2:DE'LEAD TETSUGAKUNOMICHI 507
Mailing Address - City:KYOTO
Mailing Address - State:KYOTO
Mailing Address - Zip Code:6068411
Mailing Address - Country:JP
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:40 DUKE MEDICINE CIR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-1000
Practice Address - Country:US
Practice Address - Phone:919-613-5635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-26
Last Update Date:2024-10-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NCPENDING208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)