Provider Demographics
NPI:1649338294
Name:SHEAR, EVA (PA-C)
Entity type:Individual
Prefix:
First Name:EVA
Middle Name:
Last Name:SHEAR
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 1:91-2135 FORT WEAVER RD
Mailing Address - Street 2:SUITE 170
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-1940
Mailing Address - Country:US
Mailing Address - Phone:808-676-5331
Mailing Address - Fax:808-671-2931
Practice Address - Street 1:91-2135 FORT WEAVER RD
Practice Address - Street 2:SUITE 170
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-1940
Practice Address - Country:US
Practice Address - Phone:808-676-5331
Practice Address - Fax:808-671-2931
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0002699363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical