Provider Demographics
NPI:1447341672
Name:LAU, SHIGEKO O (MD)
Entity type:Individual
Prefix:MS
First Name:SHIGEKO
Middle Name:O
Last Name:LAU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1100 WARD AVE
Mailing Address - Street 2:SUITE 1065
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1600
Mailing Address - Country:US
Mailing Address - Phone:808-599-4004
Mailing Address - Fax:808-599-4007
Practice Address - Street 1:1100 WARD AVE
Practice Address - Street 2:SUITE 1065
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1600
Practice Address - Country:US
Practice Address - Phone:808-599-4004
Practice Address - Fax:808-599-4007
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HI4093208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI04786003Medicaid
HI04786003Medicaid
HI57554Medicare ID - Type Unspecified