Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | MD 60073277 | WA |
Y | 207P00000X | Emergency Physician | MD-18075 | HI |
NPI | 1003009283 |
---|---|
Provider Name | Dr. Heidi M. Solberg-Shankle |
First Address | Honolulu, HI 96819-1469 |
Second Address | Honolulu, HI 96819-1469 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2007 |
Last Update Date | 26/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8543191 | (05) | WA |