Millard, Shane J

Millard, Shane J is an individual health care provider with primary practice located at 130 Kailua Rd Suite 111, Kailua HI 96734-3420. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Millard, Shane J can be contacted via phone (808) 261-4411.

Contact Information

Primary practice address
130 Kailua Rd Suite 111 Kailua HI 96734-3420
Phone: (808) 261-4411
Fax: (808) 466-3354
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X AMD 240 Hawaii

Profile Details

NPI number 1568444941
LBN Legal business name Millard, Shane J
Credentials AMD
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 18th, 2005
Last updated May 8th, 2023 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568444941 NPPES
Hawaii MEDICAID 56774501
Hawaii Other 56774501
Hawaii Other 0000250415

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