Provider Demographics
NPI:1467970640
Name:TEOHAREVIC, MAJA (PA-C)
Entity Type:Individual
Prefix:
First Name:MAJA
Middle Name:
Last Name:TEOHAREVIC
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95-1249 MEHEULA PKWY STE 187
Mailing Address - Street 2:
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-1791
Mailing Address - Country:US
Mailing Address - Phone:808-625-6444
Mailing Address - Fax:808-623-2552
Practice Address - Street 1:95-1249 MEHEULA PKWY STE 187
Practice Address - Street 2:
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-1791
Practice Address - Country:US
Practice Address - Phone:808-625-6444
Practice Address - Fax:808-623-2552
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-07
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty