Provider Demographics
NPI:1518286301
Name:SCANLON, MICHELLE RENEE (DO)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:RENEE
Last Name:SCANLON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:LITTLEFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:33 LONO AVE STE 305
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732-1635
Mailing Address - Country:US
Mailing Address - Phone:808-538-3232
Mailing Address - Fax:808-538-3220
Practice Address - Street 1:33 LONO AVE STE 305
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-1635
Practice Address - Country:US
Practice Address - Phone:808-538-3232
Practice Address - Fax:808-538-3220
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-19
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ4277207L00000X
HI2450207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology