Individual
DR. ELLEN K. MICKELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
46-056 KAMEHAMEHA HWY, SUITE 221, KANEOHE, HI 96744-3755
(808) 233-6200
(808) 233-6255
Mailing address
46-056 KAMEHAMEHA HWY, SUITE 221, KANEOHE, HI 96744-3755
(808) 233-6200
(808) 233-6255
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD-13156
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000253914
HMSA
HI
05
—
569618 01
—
HI
01
—
9158444
UHA
HI
Enumeration date
10/24/2006
Last updated
03/16/2012
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