Provider Demographics
NPI:1487751640
Name:ONG, SHARON HIU
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:HIU
Last Name:ONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:K
Other - Last Name:HIU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:45-1144 KAMEHAMEHA HWY
Mailing Address - Street 2:STE 500
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-3226
Mailing Address - Country:US
Mailing Address - Phone:808-247-7596
Mailing Address - Fax:808-247-7053
Practice Address - Street 1:1710 E WEST RD
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96822-2317
Practice Address - Country:US
Practice Address - Phone:808-956-8965
Practice Address - Fax:808-956-5834
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDOS762207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI07648203Medicaid
HI07648203Medicaid