Individual
GLENN M SHIOTANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
55 MAUILANI PKWY, WAILUKU, HI 96793-2416
(808) 243-6050
Mailing address
55 MAUILANI PKWY, WAILUKU, HI 96793-2416
(808) 243-6050
Taxonomy
Speciality
Code
Description
License number
State
170100000X
Ph.D. Medical Genetics
3863
MT
207Q00000X
Family Medicine Physician
Primary
MD-14631
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000277376
HMSA BILLING NUMBER
HI
05
—
620361-02
—
HI
Enumeration date
07/20/2006
Last updated
09/11/2008
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