Individual
MR. THEODORE MARSHALL MILLER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
54 3886 AKONI PULE HWY, SUITE #5, KAPAAU, HI 96755-0053
(808) 889-0044
(808) 884-5134
Mailing address
PO BOX 53, KAPAAU, HI 96755-0053
(808) 889-0044
(808) 884-5134
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
218
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C28013
HMSA HEALTH INSURANCE
HI
Enumeration date
03/18/2006
Last updated
07/08/2007
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