Individual
EVAN LOOMIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2180 MAIN ST, WAILUKU, HI 96793-1625
(808) 242-6464
(808) 424-4209
Mailing address
2180 MAIN ST, WAILUKU, HI 96793-1625
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
AMD-523
HI
363AM0700X
Medical Physician Assistant
2143
AK
Other
Enumeration date
08/04/2011
Last updated
07/23/2013
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