| Shane D Walker, PA | |
|
55 Maui Lani Pkwy, Wailuku, HI 96793-2416 | |
| (808) 243-6050 | |
| Not Available |
| Full Name | Shane D Walker |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 55 Maui Lani Pkwy, Wailuku, Hawaii |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649448572 | NPI | - | NPPES |
| 231200 | Other | WA | LABOR & INDUST |
| PA10005374 | Other | WA | LICENSE |
| 8505448 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA10005374 (Washington) | Secondary |
| 363A00000X | Physician Assistant | AMD-913 (Hawaii) | Primary |
| Entity Name | Emergency Physicians Southwest PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1912053752 PECOS PAC ID: 2264538529 Enrollment ID: O20070502000382 |
| Mailing Address | Practice Location Address |
|---|---|
| Shane D Walker, PA 55 Maui Lani Pkwy, Wailuku, HI 96793-2416 Ph: (808) 243-6050 | Shane D Walker, PA 55 Maui Lani Pkwy, Wailuku, HI 96793-2416 Ph: (808) 243-6050 |
Mr. Arthur Ruben Sakakihara - Chavarria, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2180 Main St, Wailuku, HI 96793 Phone: 808-242-6464 Fax: 808-242-4292 |
Mr. Simon Damian Hill, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2180 Main St, Wailuku, HI 96793 Phone: 808-242-6464 Fax: 808-242-4292 |
Ms. Pamela D. Wolz, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 2180 Main St, Wailuku, HI 96793 Phone: 808-242-6464 Fax: 808-242-4292 |
Judy Lavenson, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 2180 Main St, Wailuku, HI 96793 Phone: 808-242-6464 |
Rebeka Lyn Coleman, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2180 Main St, Wailuku, HI 96793 Phone: 808-242-4267 |
Mrs. Jessica Sage Blank Mendonsa, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 2120 Kaohu St, Wailuku, HI 96793 Phone: 808-377-4734 Fax: 808-377-4734 |
Mr. Philip Michael Tongg Jr., PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2180 Main St, Wailuku, HI 96793 Phone: 808-242-4267 Fax: 808-242-4292 |