Fujawa, Douglas
Fujawa, Douglas is an individual health care provider with primary practice located at 3123 W 23Rd St , Panama City FL 32405-1828. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Pediatric Dentistry. Dental Providers / Pediatric Dentistry is his primary health care specialty. Fujawa, Douglas can be contacted via phone (850) 481-1969.Contact Information
Primary practice address
3123 W 23Rd St
Panama City FL 32405-1828
Phone: (850) 481-1969
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 2901021229 | Michigan |
| Dental Providers / Pediatric Dentistry | 1223P0221X | DN23156 | Florida |
Profile Details
| NPI number | 1336541135 |
|---|---|
| LBN Legal business name | Fujawa, Douglas |
| Credentials | DDS, MS |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 23rd, 2014 |
| Last updated | Apr 19th, 2018 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336541135 | NPPES |
| Florida | MEDICAID | 023778300 |
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